Monday, January 10, 2011

Avastin

Unbelievably, at least to me, we had to wait 3 weeks to see the Oncologist about whether or not Dad was a good candidate for Avastin treatment. Yes, I am still feeling irritated about this. We had just been told that the tumor(s) were growing faster than expected, and that the Avastin might be a way to rein that in a bit. And we couldn't see the doctor for 3 weeks. I was fully ready to start making phone calls and pounding on waiting room doors to find a doctor to talk to sooner, but Dad didn't want me to do that.

So, we did online research, natch. Avastin works by inhibiting blood vessel formation, robbing tumors of the energy supply. Side effects are usually minimal, mostly involving blood leaking through thin tissue like mucus membranes. It can impede wound healing. Treatment must be stopped at least a month before any surgery. Its very expensive, and doesn't work for all types of tumors. But it has been used against Glioblastoma. With good results. What we couldn't find out online was whether Dad could be considered a good candidate for treatment, and would his health insurance pay for it. It is a very expensive treatment. I suggested at least calling the insurance company and asking, but again, that was nixed.

I don't consider myself a "do whatever it takes no matter the cost to save him" person. I understand that recovery isn't likely or expected in this case. But, damn, I want as much information as possible before making a decision. I felt frustrated, not a lot, but accepted these weren't my decisions anyway.

While we were waiting to see the oncologist, my sister and I discussed the future. Dad wants to stay in his own little place to the end, or as close to it as is safe and practical. We agree with him, we want him to be happy, and truthfully, no matter how horrible this might sound, neither of us want to move him into our homes. We did feel that getting hospice involved early was a good course of actions and wondered how to bring it up with Dad, but then he brought it up first.  More on that in the next post.

Finally appointment day arrived and 5, yup 5 of us crowded into an exam room. Dad, his girlfriend L, my sister, her very supportive husband, and me. Here is what we learned, in a rather large nutshell; Dad is a candidate for treatment, treatment means coming into the office once every 2 weeks for the rest of one's life and spending about 2 hours hooked up to an I.V. while the drug is administered. Health insurance will pay for the treatment. Effectiveness is tracked by periodic MRI scans and symptom severity. Possible extension of life expectancy, zero to a few months.  Dad declined treatment. He didn't say why.

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