More scans - possible treatment changes

Max had his MRI and BMA (bone marrow aspiration) yesterday (Monday). It was a long day. Melis and he didn't get started until noon and got home around 8:15pm, because he needed platelets as it turned out. Max awoke from his BMA quite sad and in a lot of pain, which luckily was brought under control very quickly. He's still very sore and I suspect he won't be too active today during his kindergarden carnival celebrating the end of school. Oh well, at least he's there and and not at clinic!

We're also considering some possible changes to his treatment. I'll post those to the 'Max's Current Treatment Protocol' section on the right column of this blog as soon as we formalize our decisions. To give you an idea, this is what we're thinking of doing (all or some of these would be in addition to what we're already giving Max):

- Adding oral etoposide (VP-16). This is a chemo drug somewhat similar to the topotecan that he's currently taking though it inhibits the topoisomerase II enzyme instead of the topoisomerase I enzyme. It's well-tolerated and some of the kids have done extremely well on it, though there is some risk for secondary leukemia and so we're looking into those risks more closely before making a decision whether we add this to the mix. Another concern is overall toxicity as Max is starting to show signs of cumulative toxicity from the now 9 rounds of IV chemo that he's received since relapse.

- Adding Celebrex for COX-2 inhibition (by selectively inhibiting the overexpressed COX-2, allows p53 to work properly. Functional p53 allows DNA damaged neuroblastoma cells to commit suicide through apoptosis, halting tumor growth).

- Adding Tetrathiomolybdate for anti-angiogenesis effect (tumors need blood supply to grow and so need blood vessels to bring blood to new tumor growth - slow down the growth of new blood vessels and you slow the tumor growth).

- Added Silymarin/Curcumin (thanks for the idea Meryl). A natural supplement anti-inflammatory that functions similar to Celebrex.

- We're changing administration of the Zometa to day 1 of chemo from day 5+3(Zometa is a bisphosphonate - when tumor spreads to the bone marrow, it signals to natural bone destroyer enzymes to "make me some space" so that the tumor can grow - bisphosphonates halt that destroyer enzyme - no space, no tumor growth and stronger bones, we'll take that!)


Anonymous said...

Watching him run around the carnival, having a balloon sword fight with his friends, and eating a cupcake from the cake walk you'd never know he had all those tests yesterday!! He amazes me, and I am so glad that he was here today.

Randee said...

I am not going to pretend to understand the treatment regime; it always sounds encouraging when new directions are available. I do know how great it was to see Max running around eating Hot Dogs and Chocolate Cake with all his cousins (and extended cousins) at the Semi Summer Birthday Blow Out on Sunday. To read Ms. Weitz's comments sounds like Max had another fun time at the carnival on Monday!! What a kid!! Our own super hero!! Love Annee Ranee PS Ms. Weitz thank you for all you've done to make Max's kindergarten days so wonderful!!

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