Yesterday we met with the neurosurgeon who will be part of the team that will perform the Gamma Knife procedure on Collin. The procedure will be done on Tuesday December 27. It is an outpatient procedure, so Collin will be home that night, but it will be a very long day (starting at 6:30 am).
Collin was also seen by his oncologist yesterday. She doesn't want to have him off any kind of treatment for too long, so she started him on the oral metronomic therapy last night. It consists of five different drugs, four of which will be given at home. Two are chemo drugs which he has had before, Etoposide and Cytoxan, which will be given on alternating 21-day cycles (he started back on Etoposide last night). Since he has already had multiple doses of them during past cycles of chemo, he can only take these drugs for six months because at least one of them has a potential risk of Leukemia as a secondary cancer. The other two drugs that will be given at home are drugs originally developed for other purposes that happen to have anti-cancer effects. One is Celebrex, a pain reliever used for arthritis. The other is Thalidomide, originally developed to prevent morning sickness. (Yes, the drug that caused birth deffects in the 60's is one more dangerous chemical I will give my son in hope that it will cure his cancer. As with the Accutane earlier this year, I had to sign papers saying that I understand the dangers of this drug, and must wear gloves while giving it to Collin. It's pretty scary to think about really, on many levels). The fifth drug is Avastin, which is used to treat various types of cancer. It is a type of medication called antiangiogenic agents, which work by stopping the formation of blood vessels that bring oxygen and nutrients to tumors. This may slow the growth and spread of tumors. The Avastin will be given intravenously every few weeks; one of it's possible side effects is that it can slow surgery and wound healing, so the timing of the infusion will be planned around any surgical procedures. (If Collin is accepted into the 3F8 trial at MSKCC, he will need to have an Ommaya Reservoir, kind of like a mediport in his head, placed by a neurosurgeon, so the Avastin wouldn't be given before that so there are no problems with healing from the surgical procedure). Along with these five drugs in the metronomic protocol, Collin will have to go back on Prevacid to prevent heartburn caused by the Celebrex, and Miralax to prevent constipation caused by Thalidomide.
MSKCC's tumor board will review Collin's case today and decide whether they will allow him into their study. Hopefully we will know their decision in the next few days.
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