Saturday, September 5, 2009

what we look forward to this week

Coming up this week:

1. A visit by two of Mom's Korean friends. (More may be scheduled. Keep 'em coming!)

2. A visit from the washing machine repairman. Our washer has been doing laundry three times a day for reasons that I am still loath to mention on the blog (though as I said a while back, we're eventually going to have to talk about what's been going on).

3. A visit from Mr. Jeong, the contractor in charge of our house's renovation. We have a couple small problems that need looking into (drawers and cabinets), and one large problem as well (dining room air conditioning).

4. On Friday, 9/11, we'll be taking Mom to the National Cancer Institute for the start of the aggressive, second-line phase of her therapy. The gloves are off now; standard therapy has been tried, and we've patiently taken Mom through the initial steps. Now we move to the harder stuff-- Avastin, or whatever other therapies seem appropriate. So on 9/11, Mom will have blood work done, and an MRI scan will, at long last, be performed (the last one was the controversial scan of July 20). Five days after that, we will go as a family to listen to Dr. Fine (or his cohorts/minions) to find out what our options are. One thing I plan to stress to these new docs is that Mom is not a set of statistics. I don't mind the idea of enrolling Mom in a clinical trial, but we'll need some indication that she'll be put into a trial that benefits her, not one in which she might end up as part of a control group receiving no treatment. That's my own personal Line of Death: Mom will not be part of a control group. And I want similar caution to be applied even to non-experimental treatments: before the docs commit to a certain established therapy, I want to be sure that they've considered Mom's own probable response to it. Avastin is a case in point: there's no use in putting Mom on Avastin if it turns out she's one of the 50% who don't respond to it. Test her first, then proceed-- don't assume she's "likely" to respond to Avastin just because the statistics say so.

More items will be added to the calendar as we think of them, but these are the major activities for now. For myself, I need to study up on the various therapies I've discovered. 9/11 isn't that far away.



melancholy donut said...

kev, in clinical trials is it allowed to stipulate that you wont enter unless you are not a part of the control group? or are there clinical trials where there are no control groups?

stay strong and hang in there. -h

Kevin Kim said...

I see your point: in trials with control groups, the patient can't know whether s/he is part of that group-- otherwise, results might be skewed and the placebo effect will be harder to detect. Which leads to the question of whether there are, in fact, trials in which all the recipients of the new treatment do, in fact, receive that treatment.

I suspect the answer lies in the concepts of "Phase 1," "Phase 2," etc. clinical trials-- as a treatment method's reliability is proven in phase after phase, the need for a "virgin" control group may decrease. I'm not sure. I'll look into it. Perhaps I "spoke" too soon.

Ah-- according to Wikipedia, clinical trials come in all shapes and sizes. One type is the "compassionate use" trial, which is for patients who have failed to respond to regular treatments. I need to read the article more thoroughly (and research clinical trials elsewhere), but from what I gather, it's at least conceivable that not all clinical trials require "virgin" control groups.

Kevin Kim said...


The Wikipedia article makes an interesting point: many studies will compare a new technique with the current standard of care instead of using "virgin" control groups. This makes sense for people with, say, GBM: it would probably be considered unethical for the control group to be composed of people whose cancer is allowed to grow unchecked.