Well we just got back from K-State where Syd had a CT scan and lung radiographs redone. Good news and bad news. The CT scan and x-rays still showed that "suspicious thing" in his left lung, but now the oncologist thinks its one nodule of lung mets less than 1cm in diameter. She said that it was round and classic lung met module. She said the good news is that it hasn't grown any. But the bad news is that Syd now has lung mets. :'-(
She said that I have several options. When I first learned of this suspicious thing back in January, I had asked the other oncologist about surgically removing the lung mets and doing chemo. She told me they normally have to be lung mets free for 200 or 300 days before they consider that surgery. However the oncologist today said one of the options we have is the aggressive option of going in and surgically removing the nodule, then starting on carboplatin for 4-5 tx. The surgery would be like $1500, and each carbo tx would be I think she said $1000-$2000. (can't remember exactly what price she told me right now). I asked her about the cancer vaccine and she said CSU does it, but they would probably let them administer it at K-State, but they want a donation of $1500 to do it. For the life of me, I cannot remember if she said that while he was getting this done, he would be off the piroxicam study until he was done and then resume back on it or if he would be done officially once we did the surgery.
The second option would be to maintain what we've been doing with the clinical trial "P" pill and get lung radiographs taken in two months. She also said the radiologist with the CT scan study would be willing to do another CT scan at that time at no charge to me. We discussed a little about the pills he's been getting and how piroxicam works. She mentioned something about Cox 2 inhibitors or something that slows down the growth of tumors. She said because of the short duration since dx and removal of the primary tumor (7 months), she said having lung mets show up was not good to have, but right now, he only has ONE nodule and no others showing. She said an average from time of removal of the primary tumor to progression of the disease normally is about 300 days. Of course with this, it was 6 months for Syd. She said if he were, indeed, getting piroxicam, it might be slowing down the growth of that nodule as well as any other microscopic nodules that can't be seen by CT scan or x-rays.
The third option would be to break open the code of the clinical trial pill to see exactly what he's been getting. If he's been on the piroxicam, I could then purchase the pills to give to him or do anything else I wanted to do for treatment. I again mentioned ARTe and she said she hasn't done a lot of research on it, but if they break open the code, I would be free to pursue any treatment of my choosing.
She had initially told me when I first started the clinical trial, that once the disease progressed (i.e.--lung mets), that Syd would be removed from the study and they would tell me what he's been on and I could proceed with treatment of my choice then. However, she said that because he is otherwise a healthy, vibrant dog with only ONE lung met module that hasn't grown since 1/29/04, she said he would be allowed to stay on the clinical trial.
I did remember what someone had said about her oncologist or vet purchasing carboplatin online cheaper than what she was quoted from the oncologist. I asked my oncologist about the possibility of my vet administering the carbo if he could order in cheaper online. She said carbo isn't one of the drugs that she would be too concerned about a vet being able to administer, unless he just didn't want to. She said their pharmacist probably gets the drug from someplace cheaper and they don't mark up their drugs like private practices do. However I think there's a huge difference between $489 and $2000 per treatment. Of course, now that I think about it, it must go by weight and maybe they have to use so many vials per weight, thus the costlier expense (maybe it's $489 per vial and he needs 4-5 of them since he's 118 lbs). She did say that Syd had gained 1 pound in the past 2 weeks and she would prefer him even being less weight than 118 lbs, just for his posture, getting around benefit, etc.
She did say that if we don't do the surgery, that there have been dogs with lung mets that have lived for another 6 months before encountering any problems. She said yes, lung mets are not painful. It's the complications of things like tumors pressing on an airway, etc that cause the problems. She said a dog or person can actually live with a LOT of lung mets present before they cause any problems. So she said with this one nodule NOT having grown since 1/29/04, that's a good sign that maybe he's on the piroxicam. I know she doesn't know for sure, but when I told her I needed more pills, she got up and said she would go get the piroxicam and then corrected herself quickly and said the "P" pills.
Unless my vet could do the surgery and carbo for a lot cheaper than K-State charges AND it would extend Syd's life to a good qualify of life, I just don't think we can afford the surgery and carbo. And for that I feel like some of you have....guilty that I cannot do more. I know, I know, I've been able to do a lot for Syd already, but you still get thrown back into that helpless feeling again. How can I look into Syd's eyes and tell him I'm sorry, but I cannot afford all that I can do to help him? Of course, he's still goofy and doesn't know that he's terminal and that also just breaks my heart knowing he is. I know that I am very fortunate right now as others have their dogs that are not in such a good position health wise. But I am just heartbroken. I know I'll be like Leslie and be in a little bit of funk for a few days until I decide what I want to do.
Thanks for listening. My thoughts and prayers are with all my friend's dogs who are going through worse times than Syd.
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