Plan C

Posted by April on February 3rd, 2009 filed in Medical

Hello,

Just thought I would quick update you on Joel’s treatment.  As we had previously guessed, Joel was discharged from the clinical trial he was participating in.  Last week, we met with Joel’s oncologist, Dr. Paul Helft, to see what our options are now.  (It is interesting to note that the Taxol drug that was making Joel so sick was not the problem.  Unlike most chemotherapy drugs that can be administered with saline solution, Taxol must be administered with Cremophor — which 1 to 2% of the population is allergic to.  Joel would be in that 1 to 2%.)

The oncologist discussed with us our options at this time:  standard therapy, another clinical trial at IU or looking elsewhere (such as MD Anderson in Houston, Texas) for a clinical trial there.  Joel and I are very comfortable with the treatment he is receiving here at IU and have great faith in the doctors here, so we quickly ruled out going elsewhere for treatment.  Currently, there is not another clinical trial that would be a good fit for Joel — though we will be keeping our eyes open if one should arise.  So Joel is beginning standard treatment.  His oncologist suggested one of two treatments.  The first treatment option is a chemotherapy drug called Taxotere, which is administered with saline solution and thus has a small chance of causing a reaction.  Though it is more commonly used for stomach cancer, that just brings us back to whether Joel’s cancer began in the stomach and moved to the esophagus, or if the cancer originated in the esophagus and moved into the stomach.  Another treatment option is a three drug combination called EOX (Epirubicin, Oxaliplatin, Xeloda), which reminded us of the clinical trial Joel was just participating in.  Two of the drugs are administered via IV once a month and the third drug is taken daily in the form of a pill.  The doctor explained to us last week that though he would suggest trying the three drug combination treatment first, at least one of the drugs is technically not FDA approved for esophageal cancer — thus the insurance company may not pay for it.  Unsurprisingly, the insurace company stated that they would not pay for the EOX treatment.  Joel begins his chemotherapy treatment today.  Joel and I were under the impression that he would be receiving the Taxotere treatment — the single drug therapy that would require Joel to receive chemotherapy on a weekly basis.  To our surprise, Joel’s wonderful oncologist made a few phone calls on our behalf and got the EOX treatment approved!  In two months Joel will be given another scan to see how the drugs are working.  If the chemotherapy is shrinking the cancer, he will remain on it.  If there is no improvement, his doctor may try another drug or see if a suitable clinical trial is available.  The goal is to get Joel back in remission and keep him there.

The kids were supposed to have a half day of school today.  Due to the several inches of snow that have fallen this morning, the school district has decided to keep the students all day to give the crews time to clear the streets by the end of the school day.  That might be a challenge since it continues to snow.

Hope all is going well where you are.  We will keep in touch.

April


12 Responses to “Plan C”

  1. Carrie Peigh Colvin Says:

    Joel and April,
    This is wonderful news!! Thanks for the update.

    Love you both,
    Carrie

  2. Connie Matalon Says:

    Hi April,

    Thanks for the update. It IS good news that Joel is going to receive the EOX treatment. Stan and I are also hoping that Joel gets back in remission—FOREVER.
    Cousin Connie

  3. Julie Niezer Says:

    Joel and April,

    Glad to hear your oncologist is so fabulous! Prayers continue to be answered in one way or another and therefore, we will keep them coming! This is great news…thanks for sharing and keeping so many people updated. Let us know if you guys need ANYTHING…! Take care and enjoy the snow! Julie & Ned

  4. Beth Marzolf Says:

    Joel and April,

    You are all still in our prayers even though we have not talked in a while. Please call me if we can help with the kids! Ashley misses seing Rachel.
    Beth

  5. Paula Cooprider Says:

    What great news! I see why you like the doctor. I agree this is an answered prayer. I didn’t realize the treatment was to begin today. (If I remembered how Carrie told us to make a frowny face on the computer, I would make one now because Purdue just lost the game.) Thanks for the very thorough, understandable explanation of the tretment plan. Hopefully it will get Joel into remission. Didn’t think about the cause of the reaction being the solution in which the drug is administered. Wish I had read your entry earlier- I would have had more time to enjoy the news today. Hope the treatment went well-will talk to you soon. Love, Paula

  6. Holly Says:

    April,
    We’re all praying for Joel and your family daily. You know if you need anything, we’re not too far to help. Daphne let Megan know that Joel was starting a new treatment and I was glad to see a new course of action. It sounds like a plan! Thanks to you both for making time to update. We’re here to help…just let us know what we can do.
    Love,
    Holly

  7. Steve and Esperanza Says:

    Glad to hear of the new treatment plan. It sounds like a winner (unlike Purdue vs. OSU tonight!). That was awesome that your doc took on the insurance company and won on your behalf. I have to believe that is relatively rare nowdays.
    Steve

  8. Karen Allen Says:

    Way to go Dr. Helft! Thank you for the update April.

  9. Tammy Rowshandel Says:

    I do not know Joel, but I had Mr. Peigh as a teacher in high school. He was a very kind man and I wish his family well. As an elem. principal, children are extremely important to me and I will pray for the best for your whole family. Blessings! -Tammy

  10. Judy Smith Says:

    Joel & April
    So glad to hear the news. Thanks for keeping all updated. Will continue to keep you all in my thoughts and prayers. Take care & good luck.

    Judy

  11. Jamalyn Says:

    April and Joel–Thanks for the update. I am so glad you have an aggressive doctor. What an answered prayer to be taking the EOX. (By the way, do you have to have a biology degree to follow all of this??) We continue to remember you in our prayers and have our church praying too. Thanks for the update–we’ll share the news.

    Love,
    Jamalyn and Dave

  12. Dan O Says:

    Greetings Joel and April,
    Joel, I was impressed with your memory of inspiring sports facts and moments in time in your last entry. Kerry’s sister, who works in the Vigo Cty. Sch. Corp., told us that your “Sports and how things work out” entry was in hard copy and being distributed at the Vigo County School Corp…you know you are a huge when you are big in Terre Haute!
    April, It was good to read that Joel is going to receive the EOX treatment. Thanks for the update.

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