We have good news and better news. The good news is that we have settled on a treatment option. The better news is that we start treatment tomorrow (Thursday, 1/18/07).
The decision-making process started yesterday when we paid our first visit to MD Anderson. It was an impressive facility and the people were friendly. We felt very comfortable there. We were assigned to a team led by Dr. Wen-Jen Hwu (pronounced "who"), a doctor who came to MD Anderson from Memorial Sloan Kettering in New York. She presented us with two treatment options. The first option involved a study in which one group of patients receives one of the most common chemotherapy drugs (DTIC) and the other receives treatment with an experimental chemotherapy drug called Temozolomide (spelling may be wrong). Dr. Hwu created this international study and believed the experimental dose would prove more effective than the standard treatment of DTIC, but she could not guarantee that I would be in the group that received the experimental drug. The second option she presented is referred to as Biochemo because it involves a cocktail of traditional chemotherapy drugs along with a cocktail of drugs designed to boost the body's natural immune system. This is an aggressive in-patient treatment that can produce a quick response. Dr. Hwu recommended this option as the best for me and said she could work with my local oncologist in Milwaukee to administer the treatment.
Dr. Hwu made a positive impression on us. She was very competent, professional, intelligent, and friendly. What really stood out in our minds, however, was that she obviously had a lot of respect for Dr. Sewa Legha (pronounced "Leg-uh"). Dr. Hwu knew that we were going directly from MD Anderson to meet with Dr. Legha, and she mentioned that she has known Dr. Legha for quite some time, that he had worked at MD Anderson for many years, and that he was well liked at MD Anderson. She also mentioned that the Biochemo treatment option, which she recommended to us, was developed by Dr. Legha while he was at MD Anderson. Finally, she asked us to let her know if Dr. Legha recommended something other than Biochemo. The way she asked that question gave us the impression that she highly respected his opinion as a doctor.
So we felt as if we were visiting a guru when we came to Dr. Legha's office at St. Luke's, which is literally right around the corner from MD Anderson. He was very personable, mentioning that he studied in Wauwatosa at the Medical College there while he was a young doctor. He spent a considerable amount of time asking personal questions: how many children did we have, what were their ages, what did my parents do, what did I do, which magazines did I write for, and so on. He then recommended the Biochemo option to us. He did not recommend that we do it in Milwaukee, though. He said the effectiveness of Biochemo, which is a particularly aggressive form of treatment, is dependent in large part on the skill of the person administering it. He said the doctors at MD Anderson could administer it properly and that he, being the person who developed the treatment, could administer it properly. But he said no one in Milwaukee could do it properly and therefore we were not going to get the full benefit of the treatment if we did it in Milwaukee. He said if we really wanted the best shot at beating it, we needed to stay in Houston for treatment. He was very complementary of MD Anderson, but it was obvious that he was very confident in his ability to treat melanoma.
We quickly decided that Biochemo was the best option and that seeking treatment in Houston made the most sense. The question then became: do we go with MD Anderson, which is arguably the best cancer center in the US, or do we go with Dr. Legha, who developed the melanoma treatment that MD Anderson recommended to us. We decided on the latter. As impressed as we were with MD Anderson, we could not walk away from the chance to seek treatment from the man who pioneered the treatment and who was obviously held in high reverence by the MD Anderson doctors. If this treatment does not work, we will still be able to seek alternative treatments at MD Anderson. I sought consultation from Dr. Jim Cox, a melanoma scientist at the University of Missouri who also happens to be the brother of a very good friend of ours. He said the treatment I was seeking was exactly what he would do. That made me feel very good about my decision.
Here are the specifics on my treatment. It consists of three chemo drugs--Cisplatin, Vinblastine, and DTIC--that are designed specifically to kill cancer cells and two bio drugs--Interferon Alpha and Interleukin-2--that boost the immune system. These drugs are given to me over a 96 hour period. Some are given continuously, others are administered in small doses at regular intervals, and one is given as a daily shot. After five or six days in the hospital, I will be released to recover for two weeks. At the end of this three-week cycle, I am again admitted to the hospital and the process starts all over again. After two cycles, I am rescanned. Hopefully, the cancer will show signs of shrinkage. If so, Dr. Legha will administer two more cycles and rescan again. Hopefully it will show more signs of shrinkage. The treatment will continue for two more cycles and, if everything goes well, a final scan will show that the cancer has gone away completely. If any scans show that the cancer has grown, treatment will stop immedately and we will have to pursue another course of treatment. Please pray that the six cycles will do the job.
I am to report to Dr. Legha's office tomorrow morning at 8:00 a.m. to start the admissions process and should be hooked up to the machines by evening. Kelly will stay with me while I'm in the hospital, then she will go up to Milwaukee and somebody (hopefully my mom) will come down to be with me here. Kelly's primary order of business at this point is to find us short-term accommodations where I can stay for the many weeks -- treatment could last for four months -- when I am not in the hospital. There are lots of hotels around the Medical Center here and several contacts in the area have recommended some places we should consider.
Thank you to the many people who have called, emailed, and helped out in so many ways. You cannot imagine how good it makes me feel to know people are praying that I beat this.
God bless you all. And wear sunscreen (especially if you're one of my kids, siblings, or maternal first cousins; melanoma is a familial cancer)!
PS. I have asked Katie Clancy to post an article that describes the treatment in more detail; you can read it by visiting her site at www.doddfamilyfund.com; you might need to give her a few days so that she has time to get it up.