FIRST THE GOOD NEWS :)

YIPEE DIPPEE DOODAH.......

After two cycles of weekly paclitaxol with Herceptin Peters tumors are shrinking, the liver nodules are half the size and the oesophageal cancer is less dense. As per my previous post we were expecting a good CT result as CEA-19 and CEA markers have been dropping since trial chemo combo commenced, but it was a far better result than we could have hoped for.

This is a major event for Peter as treatment is palliative not curative, his team are delighted and we had a lot of hugs and laughter during yesterdays consultations.

Mugga scan was fine as was his Hb so Peter had herceptin as planned.

But ........ On Monday after noon it was obvious Peter was bleeding again he was vomiting black (coffee grounds) and stools were black I made an executive decision to observe him over night,   and get him to The Marsden as planned on Tuesday, I calculated that this was digested blood so not an acute bleed, I started Metoclopromide and the sickness subsided overnight.

Its obvious from the first part of this post that we made it to London. where Peter had CT and Mugga scans. ECG and blood tests. His weight is down again .

As well as the good news the CT also revealed multiple blood clots in his lungs, so yet again we are between a rock and a hard place, given the GI bleeding the conventional treatment with blood thinning is risky but so is the risk of a pulmonary embolism. therefore a swift MDT was convened.

The plan.

• split the dose of Tinzaparin  meaning twice a day injections at 8am and 8 pm.

I have to say I am very proud of his bruise free tummy if I say so myself my technique is perfect so much so that his team asked where I am giving it as no trace when they examined him . The trick is to conserve the air bubble if you have to adjust the dose (as I do) , then insert needle,then very slowly push plunger I do it to a count of 15 then leave needle insitu for a further count of 10 before removing. He has very little fat yet he says it doesn't hurt either.

• Radiotherapy to Oesophageal tumor to try and seal bleeding points this will be done daily for 5 days. we haven't worked out the logistics of this yet but we can do it.
• WBC is dropping and is expected to go down more with radiotherapy meaning Paclitaxol will be stopped or delayed.
• Trial may be compromised if he has to miss doses, advise is being sought from trial coordinator as to how many doses may be missed or delayed if necessary before Peter would be removed from the trial.

Peter as usual took all this in his usual stoic laid back fashion , when asked if he had any questions he said "No, my wife understands it all I just do as I'm told and its worked fine so far". You got to admire such blind faith.

Best Wishes to all we will be out in the garden today celebrating the shrinking tumors with a glass of something cool and high calorie.