CONTACTS 

SUBJECTS
Kaiser Schedule Meeting UCSF Qualify Millie Clinical Drug Trials Cet

2203 -
2203 -    ..
2204 - Summary/Objective
2205 -
220501 - Follow up ref SDS 57 0000. ref SDS 56 0000.
220502 -
220503 -
220504 -
220505 -
220506 -
220508 -  ..
2206 -
2207 -
2208 - Progress
2209 -
220901 - UCSF 2 Drug Trial Proposals Kaiser Collaborating to Help Millie
220902 - Drug Trials Kaiser Collaborating UCSF Consider Proposals Help Millie
220903 -
220904 - Follow up ref SDS 57 086H, ref SDS 56 086H.
220905 -
220906 - Background on Kaiser collaborating with UCSF on drug trials for Millie
220907 - is reported on 061228. ref SDS 56 086H
220909 -  ..
220910 - Millie received ref DRT 1 0001 from the primary care physician dated
220911 - 061231 transmitting language from a letter Kaiser received from UCSF
220912 - that follows up Kaiser's letter dated 061229, ref DRP 9 0001,
220913 - answering questions UCSF submitted on qualifying Millie for treatment
220914 - under clinical studies at UCSF, and reviewed in the record on 061230.
220915 - ref SDS 57 PN5X
220917 -  ..
220918 - Letter from primary care physician says...
220919 -
220920 -    1.  This is [UCSF's reply to Kaiser's answer on 061229 to questions
220921 -        submitted by UCSF on qualifying Millie for drug trials]...
220922 -        ref DRT 1 0001
220924 -  ..
220925 - Doctor Rugo replies to primary care physician at Kaiser...
220926 -
220927 -    2.  Probably to see me. Can you send her name and birthdate?
220928 -        ref DRT 1 PZ5M
220930 -  ..
220931 - This responds to question in Kaiser's letter on 061229 asking about
220932 - scheduling a meeting for Millie at UCSF to see a doctor, reported on
220933 - 061230, ref SDS 57 RM4H, this letter indicates Doctor Rugo will likely
220934 - meet with Millie.
220935 -
220936 -            [On 070102 notified Millie's daughter, Pam, about progress
220937 -            scheduling meeting at UCSF. ref SDS 58 KP5S
220939 -             ..
220940 -            [On 070109 Millie requests Kaiser to notify UCSF that
220941 -            measurable disease observed during examination on 070105
220942 -            IBC spreading from left to right breast; Kaiser suspends
220943 -            treatment to enable patient to qualify for clinical study
220944 -            drug trials proposed by UCSF; request date for meeting to
220945 -            schedule start treatment. ref SDS 59 WZ4L
220947 -             ..
220948 -            [On 070110 Kasier's letter to UCSF on 070108 and received
220949 -            in the record on 070110 fails to perform scope planned to
220950 -            assist UCSF evaluate measurable disease. ref SDS 60 NN6I
220952 -             ..
220953 -            [On 070116 Jackie called to begin scheduling meeting with
220954 -            Doctor Rugo at UCSF. ref SDS 61 NK8F
220956 -  ..
220957 - Letter from UCSF transmitted by Kaiser continues...
220958 -
220959 -    3.  One issue will be measurable disease or not, as the study
220960 -        requires measurable disease. ref DRT 1 BO6F
220962 -  ..
220963 - Letter to Kaiser on 061228 reviewed findings of measurable disease for
220964 - submission to UCSF. ref SDS 56 T66Y  Subsequently, on 061230, Kaiser's
220965 - letter to UCSF presented only elevated CA 15-3, and mild FGD activity,
220966 - ref SDS 57 PO3V, reported on the PET/CT test on 061227, and did not
220967 - present findings prepared for the doctor in the letter on 061228.  The
220968 - reason for failing to present findings of measurable disease to UCSF
220969 - is not clear in the record.  Background on this issue is reviewed
220970 - again below. ref SDS 0 4Q6K
220971 -
220972 -               [On 070116 Jackie called to begin scheduling meeting
220973 -               with Doctor Rugo at UCSF, and said UCSF medical team is
220974 -               working on issue of measurable disease. ref SDS 61 UM8K
220976 -  ..
220977 - Letter from UCSF transmitted by Kaiser continues...
220978 -
220979 -    4.  I look forward to hearing from you, and will then work on
220980 -        setting up an appointment for her, thanks for your email.
220981 -        ref DRT 1 LO6J
220982 -
220983 -               [On 070116 Jackie called to begin scheduling meeting
220984 -               with Doctor Rugo at UCSF. ref SDS 61 NK8F
220986 -                ..
220987 -               [On 070118 Jackie called to schedule meeting Doctor Rugo
220988 -               on 070119, and begin treatment. ref SDS 62 1G3K
220990 -                ..
220991 -               [On 070118 Jackie called and advised treatment may be
220992 -               delayed because authorization for payment has not been
220993 -               arranged; working to get documentation from Kaiser.
220994 -               ref SDS 62 YF8U
220996 -                ..
220997 -               [On 070118 Millie notified primary care physician that
220998 -               UCSF will call on 070119 to get documention required
220999 -               to start treatment. ref SDS 62 PK6M
221001 -                ..
221002 -               [On 070119 Kaiser signed authorization for Millie to get
221003 -               treatment at UCSF; treatment delayed because there was
221004 -               not enough time for doctors to resolve policy conflict
221005 -               between Kaiser business units involving Medicare.
221006 -               ref SDS 63 AS4K
221007 -
221008 -
221009 -
2211 -

SUBJECTS
Measurable Disease Case Study IBC Considertions Defining Practices R

2403 -
240401 -  ..
240402 - Case Study IBC Measurable Disease Photographs Tape Measure
240403 - Measurable disease has been reviewed previously in this case...
240404 -
240405 -
240406 -        1.  IBC is a tumor that occurs in the skin and does not
240407 -            necessarily register as measurable lymphadenopathy,
240408 -            reported in research on 040517. ref SDS 10 TO7L  Recently,
240409 -            difficulty diagnosing IBC because image tests often do not
240410 -            identify disease in the skin was reviewed on 061228.
240411 -            ref SDS 56 H99F, and was supported by MD Anderson Cancer
240412 -            Center in a paper, also, cited on 061228. ref SDS 56 XP5K
240414 -             ..
240415 -        2.  Diagrams and photographs have been considered for measuring
240416 -            the spread of IBC rash, originally considered on 050324 to
240417 -            measure the boundaries of mastectomy surgery. ref SDS 20
240418 -            0347  On 060808 backup doctor could not assess progression
240419 -            of disease for deciding on changing chemotherapy treatment
240420 -            to improve effectiveness, because there was no photographic
240421 -            record to measure advance of disease. ref SDS 37 FQ6G  On
240422 -            061020 pictures were again considered to establish
240423 -            measurable disease for satisfying requirements to get
240424 -            treatment with of clinical studies. ref SDS 43 JQ3J
240425 -
240426 -                [On 070116 UCSF considering Millie qualifying for
240427 -                clincial study drug trial based on measuring spread of
240428 -                disease with a tape measure and photographs.
240429 -                ref SDS 61 JS5G
240431 -                 ..
240432 -                [On 070130 UCSF planning to take photographs of IBC
240433 -                rash to measure progress of disease required for
240434 -                clinical study drug trial. ref SDS 64 M661
240436 -                 ..
240437 -                [On 070201 Jackie took pictures of infected IBC tissue
240438 -                with a tape measure held in various angles to assess
240439 -                measurable disease. ref SDS 65 HQ3J
240441 -             ..
240442 -        3.  IBC rash has spread since initial diagnosis of relapse on
240443 -            060623, ref SDS 31 025H, and subsequent confirmation a few
240444 -            weeks later on 060711. ref SDS 32 025H  On 060808
240445 -            dimensions of IBC rash were reported. ref SDS 37 8Z8G
240447 -             ..
240448 -        4.  Qualifying for clincial drug trials at UCSF requires
240449 -            finding measurable disease, reported by Doctor Benz in 2nd
240450 -            opinion received on 060929. ref SDS 40 UI9K
240452 -             ..
240453 -        5.  CA 15-3 has been a continuing measure of Millie's response
240454 -            to treatment and progression of disease.  On 020607 the
240455 -            primary care physician at Kaiser relied on rising CA 15-3
240456 -            cancer marker to change treatments. ref SDS 4 4X5K  On
240457 -            061201 this occurred again. ref SDS 47 GJ5M  On 061230 the
240458 -            primary care physician cited CA 15-3 for measurable disease
240459 -            in communications with UCSF for clinical study drug trials.
240460 -            ref SDS 57 PO3V  Correlation between IBC disease and CA
240461 -            15-3 in relation to treatments is listed in a study on
240462 -            070301.
240464 -             ..
240465 -        6.  IBC rash spread from the left chest area to the right
240466 -            breast for the fist time in 5 year patient history,
240467 -            reported on 061208. ref SDS 49 3D6K  The area of skin
240468 -            involvement has continued to spread, which can be measured
240469 -            through a record of photographs.
240470 -
240471 -                [On 070109 Millie requests Kaiser to notify UCSF that
240472 -                measurable disease observed during examination on
240473 -                070105 IBC spreading from left to right breast; Kaiser
240474 -                suspends treatment to enable patient to qualify for
240475 -                clinical study drug trials proposed by UCSF; request
240476 -                date for meeting to schedule start treatment.
240477 -                ref SDS 59 WZ4L
240479 -                 ..
240480 -                [On 070130 UCSF plans to take pictures for evaluating
240481 -                measurable disease in the case of IBC. ref SDS 64 M652
240482 -
240483 -
240484 -
240485 -
240486 -
240487 -
240488 -
240489 -
240490 -
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2405 -