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Tuesday, April 28, 2009

Medical Update -- Xeloda vx. Taxotere.... and the winner is....

We arrived a few minutes late... and there were no parking spaces... so we parked right in front of the hospital, in the spaces reserved for taxicabs. Who says there are no advantages to having cancer? With a tav neichut (handicapped parking permit) you can park almost anywhere!

We went in, paid and sat down to wait...

When my Second Opinion Oncologist (SOO) came out of her room, she was surprised to see us.

"I did not expect to see you;" she said softly.

When we said down in her office, she continued, "You did not need to come. I sent you an email..."

I explained that we, particularly Moshe, had more questions for her.

She repeated what we have heard before, both from my regular oncologist and others as well: there is no 'right or wrong' answer. Even though Taxotere is an excellent, and effective, chemotherapy, she does not like it so much because of its toxicity. She prefers Xeloda, which has much fewer side effects. That said, she understands why my oncologist recommended Taxotere, and agrees that it makes sense to try it.

She did suggest that if we do choose Taxotere, a full dose should be administered once every three weeks. My oncologist recommended that I receive the Taxotere weekly (1/3 of a dose per week), like I received the Taxol. Spread out, the side effects are less severe. My SOO ceded that the difference in efficacy was not that significant.

(She quoted a study that compared Taxol weekly, Taxol once every 3 weeks, Taxotere weekly, and Taxotere once every 3 weeks. She said that Taxol weekly was the most effective, followed by Taxotere once every 3 weeks.)

When our meeting ended, the SOO told us "there is no reason for you to come to me again; you have an excellent oncologist."

Then, almost as an afterthought, she added, "except, perhaps, after Tykerb. There are several new drugs that are coming out for HER2 cancers."

She suggested that when the time comes, her hospital might be involved in research that will be relevant to me.

As we left, she repeated that we can email her with questions and that we can rely on the judgement of my oncologist. Then, again, softly, she wondered that we had come.

I wondered if I had missed some sort of subtle message when we spoke on the phone. I do not think so. I just think she thought it unnecessary, and thought that was clear. I think she was being sensitive to the fact that it costs so much money to sit with her.

Nonetheless, as we walked out, Moshe expressed his relief at having gotten our SOO's opinion. He noted that had we not gone, he would have spent his nights, laying awake in bed, wondering if we had made a mistake about my treatment. When you look at it that way, we did not waste our time or money. It was worth it for his peace of mind.

And, just so we would take full advantage of being in Tel Aviv, we went out to China Li, a nice Chinese restaurant in Tel Aviv.

Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,


Batya said...

Refuah Shleimah
There's nothing like an f2f meeting, when you have the option.

Cheryl Pitt said...

Peace of mind is such a blessing. and you got to sneak in a date with Moshe.

Per your request, a photo of the glasses :)


Melissa said...


May Hashem guide you and your doctors to all of the right decisions.

I know that He will.

Thank you for the info you left for me in my comments.

You are a dear sweet friend.

Love Melissa

Karen said...

I'm glad that you resolved it, and that you both have peace of mind. It does make sense to use the Taxotere, since the Taxol worked for you (and I assume that you can always use Xeloda later if you need it). Let me know what your new schedule is and when you would like me to come.


rickismom said...

RivkA, re your comment on "pushing"
But hopefully WE are all pushing and shoving with our prayers for you!

A Living Nadneyda said...

I'm with Moshe -- peace of mind is worth a lot, especially when so many stressors are hitting you all around.

(And a date with your husband? Priceless...)