Wednesday, December 9, 2009


We're safely back, and all the heroes who took part in a spectacular day have gone their separate ways-- David to his apartment, Renée back to Queens, Dr. Boockvar to another operation, and the rest of us back to the homestead in northern Virginia.

We've come back with fantastic news: Mom now joins about twelve other people (six more than the New York Times article mentioned) in Dr. Boockvar's and Dr. Riina's intra-arterial Avastin delivery clinical trials. Mom has, in fact, been booked to have her surgery on December 18th-- a mere ten days from now. So we'll be taking Mom back up for an MRI on the 17th, and her procedure is to be done very early in the morning on the 18th.

Thus far, none of the twelve patients has suffered any ill effects from this new method for delivering Avastin directly to a tumor site. One patient died, but this was the result of a combination of factors unrelated to the technique: (1) the patient's tumor had spread to the brain stem before treatment had begun in earnest, and (2) the patient had contracted pneumonia (see the original New York Times article that started us on this treatment path). The overall outlook for all the other patients in the trial has been encouraging.

We do still have to worry about the potential risks of such an operation. Any invasive procedure brings with it the chance of internal hemorrhage-- an especially frightening prospect where the brain is concerned. Also: Avastin is a potent drug, and as is true with all drugs, different people react differently to it. Might such a high concentration lead to some sort of brain damage, or to something worse? While such outcomes seem unlikely, based on the record of twelve patients thus far, there's always a chance that a later patient might not dodge the bullet. Keep in mind, too, that we're dealing with a very small pool of people from whom to collect data. It's still too early to be drawing general conclusions from current results, and this particular clinical trial is so new-- it started this past August-- that it's still in Phase I, i.e., the safety-verification phase. In other words, no one knows anything definite about the long-term effectiveness of the procedure.

So while I'm elated that Mom is now part of this trial, there's a knot in the pit of my stomach much like the knot that appeared when Mom first went off for her April 21 debulking surgery. Things ought to go very well, but there remains a chance-- Dr. Boockvar puts it at about one percent-- that something could go very, very wrong. Even though it's hard to argue with near-total tumor shrinkage, it would be criminal to paper over the potential risks.

I'm too tired to say much more right now; I need to review the audio of our meeting with Dr. Boockvar so I can blog later on about any other salient points. Suffice it to say that we all arrived home safely, and that Mom was, once again, a real trouper about the ordeal. She had to give a urine sample, have a blood sample taken, undergo an EKG scan and a chest X-ray, and endure, for a few minutes, the cold and wind of Manhattan in December. She spent most of the 8th starving: we fed her a large breakfast, but because we didn't realize how many tests she would be undergoing (these were all pre-operative requirements), we didn't feed her any lunch.

Renée very kindly hung out with us through the afternoon and early evening; her beau Ron also dropped by and met David. When all the testing was over and we had re-packed both our suitcases and ourselves in the minivan, we trundled over a couple blocks, bought food from a local grocery (Food Emporium), and chowed down, with Renée, inside the van. David had done some shopping as well: he surprised us with an assortment of tasty desserts, a move Renée described as "genius."

Eventually, we dropped Renée off by Bloomingdale's, and David took us out of Manhattan. Once we hit New Jersey, I took over and drove us into northern Maryland, after which David took over again and drove us the rest of the way home. The van was apparently a casualty in this trip: one headlight died, and the center brake light also gave up the ghost. Dad will be getting those repaired, and checking the wheels' balance (he sensed a great deal of vibration as we were cruising along) so that we can drive back up to NYP/WC safely on the 17th.



Jelly said...

Such good news, Kevin! I'm so glad your mom has been included in the trial and am hoping for positive reults. You and your family are so often in my thoughts.

Dale Molina said...

Glad you arrived safely home and glad that you were able to see Renee. Also glad to hear that your mom was accepted to the study. So many glads. Always thinking of you all.....Dale Molina

Charles said...

That's great news!

Kevin Kim said...

Thanks, all. Everyone keep your fingers crossed.