FathersStory's Blog

So now we go to oncologists to see what kind of treatment my son will have.  We got the name of one from the urologist who did the surgery.  And friends have been helpful in giving us names of other oncologists.  They’re all reported to be very good.

 

But they also can be hard to see.  I’ve avoided names for the most part in writing this, but I will give the names of the oncologists, because they all were flexible enough to fit us into their schedule, and were more than generous enough with their time.

 

The name of the oncologist we were given from the surgeon is Dr. Gary Grad.  At first, we wouldn’t have been able to see him for a week.  But one day as I arrived at work, his office called me on my cell phone, asking if we could see him late that day.  I called my wife and son, and they went.  I was able to listen in by speaker phone in an office at work.

 

Dr. Grad told us the tumor my son had removed was embrinal, meaning it is more prone to spread.  And a couple of features are raising concerns.  First, the blood work he had done.  There is a so-called “tumor marker” in the blood, called alpha fetaprotein, or AFP.  My son had a level of more than 200 in the blood taken before the surgery.  That’s an indicator of malignancy.  Another blood test will be scheduled for next week.  Secondly, as the urologist told us, Dr. Grad mentioned the two enlarged lymph nodes in the abdomen and the nodule on the lung.  He termed those areas “suspicious,” meaning there could be cancer cells there, but it’s no guarantee.  Dr. Grad also suggested my son have a PET scan, which would zero in on those suspicious areas and give more of an indication whether they are cancerous.

 

Dr. Grad said my son is in the third stage of cancer, which is somewhat advanced.  He said that based on the nodule on the lung.  But he also called my son a “good risk,” with a good prognosis and outcome.

 

Then he talked about the specifics of chemotherapy.  There are two accepted courses of treatment.  One is called BEP, the administering of three drugs, bleomycin, etoposide and cisplatin.  My son would have three courses of this.  Treatment the first week would be Monday through Friday, about four hours a day.  The second and third weeks would have treatment just once, for bleomycin.  The cycle would repeat three times, for nine weeks of chemo.

 

The possible side effects: there could be restrictions in blood vessels, but those  cases, we’re told are rare. It also could cause problems in lung function, but that risk is low if the lungs and kidneys are okay.

 

The second course of treatment is EP, just the two drugs etoposide and cisplatin, taking out the bleomycin.  The drawbacks here:  first, it’s four courses of treatment, so it would be a longer span.  Secondly, it can cause numbness in the extremities, which could be permanent.  And finally, in rare cases, there could be kidney damage.

 

I know doctors have to cover themselves and give all possible outcomes, including ones that are rare, but all this sounds pretty scary to us at this time.  Dr. Grad said  he will be checking my son’s lung and kidney functions throughout the treatment and will be taking blood tests to see if that AFP tumor marker falls.  One encouraging note:  Dr. Grad said the relapse rate from this type of cancer is low. 

 

            He also suggested we see a doctor in Indianapolis, Dr. Larry Einhorn, at the University of Indiana.  Dr. Grad described him as a “doctor’s doctor.”  Dr. Einhorn, we were told, was very instrumental in the treatment of Lance Armstrong.  It sounded like a great idea.

 

            Other things Dr. Grad told us.  My son would lose his hair. And he and the nurses would be monitoring my son’s white blood count.  He could develop a fever in the second or third weeks of each course.  If that happens, he should go to the hospital.  But he also said he couldn’t remember that last time a patient had to be hospitalized (remember that).

 

            So now we have a better idea of what lies ahead.  Next… more doctors, but before that, an awkward situation.