2nd Opinion Info

Today we had an appointment with Dr Harandi from Kentuckiana Cancer Institute, part of Jewish.  He spent a full hour and a little more with us today and was full of information and allowed the questions to keep coming.  We were very comfortable with him as he was very personable and acted like he very much cared.  I have so much information to share I'll do my best to share it all.  I imagine a part 2 will be needed once I go to bed and think of other things to share.  The truth is I do have a hand full of options and he even admitted that you can meet with 5 different oncologists and get a different recommendation.  I imagine he is in his upper 30's and we know he has a 4 year old and a one year old at home so I think he gets us.  He layed out the options and we eventually got down to the what would you do in my shoes.  He said he'd finish out these last 2 treatments that are left assuming I could handle them and then do a couple of things.  He recommended going down to Nashville and visit Vanderbilt and another center that are both advanced cancer centers and have access to some of the stuff that Louisville doesn't have.  He also recommended U of Chicago because all of these centers are in driving distance.  He actually wouldn't go to the centers we previously mentioned (MD Anderson and John Hopkins) because there recommendation would probably be the same or similar to what has already been laid out or if they do have something special, it's going to be a trial and I'll most likely be looking at doing treatments there which would be difficult.  Yes, the clinical trials would be good but its best to find a top notch place that is within driving distance and manageable.  Different cancers have different options but there is nothing earth shattering right for now for PC that is out there and worth moving your family or travelling extensively.  We probably won't actually find a clinical trial available to us right now because to qualify, I'd probably have to be getting worse.  Worst comes to worst, we could line something up in Nashville thats sitting there waiting in case things do "progress" or get worse.  If by chance, they do have one I'd qualify for now, he'd jump on it if had good results.  So that sends us back here probably and he'd recommend we switch the chemotherapy to gemzar and maybe tarceva which is a standard treatment.  He did not recommend waiting to see what happens and the point he sold me on was it would kind of be silly to stop doing treatments if I can tolerate it and they are working.  This line of chemo would actually be more often, once a week but it is very tolerable.  As he put it, little old ladies take this stuff and they are fine.  He said people work and do this treatment and that there's actually only about a 25% chance you'll become nauseous without any nauseau medicine.  It's evidently night and day compared to the harsh treatment I am currently on which you have to take nauseau medicine and it knocks you out for days.  He feels that if I'm responding well to this current treatment, I will respond to another.  He said I'll be able to gain some weight and strength back while doing this treatment which was a concern.  This treatment I could do an unlimited amount of so I'd be doing it indefinitely.  I asked if I'm looking at chemo for the rest of my life and he said yeah probably, as long as it works in some fashion.  By switching to this new regimen, I could keep what I'm doing now in my back pocket and go back to it briefly in the future if things start to get worse.  One option was just to remove one of the drugs I'm doing now since it's working and he said the only problem was I wouldn't really have anywhere to turn if things got worse because I couldn't add that other drug back in because my body wouldn't be able to take it.  Radiation is not really an option because I have spots in different areas and you have to localize that treatment to one spot in your body; can't shoot the liver and pancreas at same time (without serious repurcussions to the GI system).  Surgery is not an option and would be malpractice as he said because removing the tumor in the pancreas would be ignoring the liver and it would just came back; also the surgery is very difficult to recover from and often causes more complications.  If I switch to this doctor, I can get treated at the new Jewish Hospital facility closer to home.  Overall it was a good visit and we are strongly considering switching doctors.  We feel we talked to him more today then we have all the other times with our current doctor.  We want a personal investment from our doctor that we can trust and truly cares.  Most sobering news is we asked him about any successes with PC patients.  His best patients that have responded to treatments have gone on to live for "2+" years.  That brought us quickly back to reality and not what you want to here but unfortunately it's the grim reality.  I asked if I was the youngest to be treated there for PC and it sounds like I'd be second to a high 20 something year old that's no longer with us.  Hopefully I didn't leave out the most important questions for you, if I missed something big, I'll add later.