Thursday....May 28th....2009

She's back!.....how can I tell?.....well, she's "bossy" again.....she is always doing something rather than sitting....she is alert.....and more....

The Oncologist visit today was another one with much information...

First...he said she had "fallen off a cliff"....in other words, her blood counts "tanked" for no obvious reason this past week....her previous cycles had proceeded well and there was no reason to believe this one was going to be any different.

Second....he said it couldn't "have come at a worse time' with her on vacation and all...but she assured him she still had a good time.

Her blood counts today were good.....she is producing the counts again....

He is still waiting a week to start cycle 6.

He is still cutting back on the infusion amounts in the next cycle.

He is planning on starting a "maintenance program" of Avastin after cycle 6 starting the 25th of June.

Of course this assumes everything goes well with cycle 6 and he has no reason to believe otherwise.

Linda's scan will be on June 23rd....this will be a critical check and we hope it shows again what the scan after cycle 3 showed...ie., "marked improvement".

Linda is entering the hospital next week...June 3rd....to have a "port" placed in her chest...she will do it under local anesthesia and be released the same day. This, she is excited about as there will be no more needles placed in her arms trying to find veins to draw blood or do infusions....life will be easier for her and the nurses around her.

The Oncologist said she should be free to go where she wants on the 26th of June...so Linda is contemplating a trip by RV to Nebraska for three weeks...more on that later.

The Avastin maintenance cycles are also three weeks with Avastin given by infusion on day 1 and then 20 days "off".......

That is a lot of information.....ps....he said in three months she should feel a whole lot better...most of her "side effects" she is experiencing should disappear.

Tomorrow Dave visits the Dermatologist as another follow up to the PDT (Photodynamic Therapy) session he had done a while back....we then travel to Portland for two days for visits and all...then back Sunday...load the motorhome....and hide somewhere.

What is Avastin?

Avastin is a cancer medicine that interferes with the growth of cancer cells by blocking the formation and growth of new blood vessels in the tumor which slows their growth. Avastin is used to treat cancers of the colon, rectum, lung or breast.

How is Avastin Thought to Work?

In order to grow and spread, tumors need a constant supply of oxygen and other nutrients. Tumors get this supply by creating their own network of blood vessels. This process is called angiogenesis (an´-gee-o-jen´-i-sis). To start angiogenesis, a tumor sends out signals to nearby blood vessels. These signals cause new blood vessels to grow toward the tumor. Once these new vessels reach the tumor, they provide the supply of blood that brings oxygen and other nutrients to the tumor. This helps the tumor grow.

Avastin is thought to work by blocking one of the key signals that causes angiogenesis. Specifically, Avastin blocks a protein called vascular endothelial growth factor (VEGF, for short).

This may allow Avastin to affect the tumor in different ways:

Avastin may cause the blood vessels to shrink away from the tumor, blocking the supply of oxygen and nutrients that the tumor needs

Avastin may also cause the existing blood vessels to change in ways that help the chemotherapy reach the tumor more effectively

Finally, Avastin may interfere with the growth of new blood vessels, potentially helping to block further growth and spread of the cancer