CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 4 0000, ref SDS 3 0000.
040502 -
040503 -
040504 -
040506 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Yesterday, there was a lot of correspondence on doing an FNA or core
040902 - biopsy to test for status change.  Millie sent a letter late last
040903 - night to the primary care physician, with copies to the medical team
040904 - at Kaiser and UCSF, and summarizing the goal to qualify Millie for
040905 - participation in the sunitinib clinical trial. ref SDS 4 V47L
040907 -  ..
040908 - Millie received another letter this morning from Doctor Daamen with
040909 - Head and Neck Department at Kaiser in Walnut Creek.  The doctor sent
040910 - copies to the medical team at Kaiser and UCSF addressing the medical
040911 - procedure to test for status change.  Yesterday afternoon, Doctor
040912 - Daamen scheduled Millie for a core biopsy procedure this morning at
040913 - 1130.  In the evening, UCSF reponding saying status change can be
040914 - tested with an FNA biopsy, ref SDS 3 4Q52, and in a second letter
040915 - seemed emphatic saying hopefully a core biopspy will not be needed.
040916 - ref SDS 3 KY8R  This was cited in Millie's summary to the primay care
040917 - physician late last night, ref SDS 4 4T9S, which said Millie would be
040918 - willing to try another FNA procedure to test for status change.
040919 - ref SDS 4 4T9V
040921 -  ..
040922 - Doctor Daamen's letter from Kaiser this morning does not respond to
040923 - Millie's letter to the medical team.  The doctor responded to Doctor
040924 - Rugo's letter at UCSF earlier that discussed tring to do an FNA
040925 - biopsy.
040926 -
040927 -    1.  Subject:  FNA Biopsy Positive for Cancer; Need Core Biopsy to Test Status Change
040928 -        Date: Fri, 24 Oct 2008 08:00:47 -0700
040936 -         ..
040937 -    2.  Hello-
040938 -
040939 -        As mentioned prior, I have been told by the
040940 -        immunohistochemistry lab in SF through our pathologists that we
040941 -        need formalin fixed tissue to do the Her2 testing- cannot do on
040942 -        FNA specimens.  They may be able to do the ER PR on a repeat
040943 -        FNA.
040945 -  ..
040946 - Doctor Daamen responds to UCSF's letter yesterday evening saying
040947 - hopefully status change can be tested with an FNA and not a core
040948 - biopsy. ref SDS 3 KY8R  Brigid issued an order for Doctor Rugo on
040949 - 081016 that specified an FNA biopsy of a lump in the left
040950 - supraclavicular to test for status change. ref SDS 1 J36R
040951 -
040952 -            [On 081024 Millie asks primary care physician to coordinate
040953 -            solution to Kaiser proposing core biopsy to accomplish UCSF
040954 -            order for FNA biopsy to check status change. ref SDS 5 579O
040956 -             ..
040957 -            [On 081024 Doctor Wong confirms Kaiser cannot check for
040958 -            status change with core biopsy, ref SDS 6 KE6J; and relates
040959 -            that core biopsy is higher risk for Millie's patient
040960 -            profile than using less invasive FNA biopsy possible at
040961 -            UCSF. ref SDS 6 W183
040963 -             ..
040964 -            [On 081029 sunitinib work plan update proposes doing FNA
040965 -            biopsy at UCSF to check for status change. ref SDS 7 SF3P
040967 -             ..
040968 -            [On 081101 Doctor Rugo says FNA biopsy to check for
040969 -            status change is not part of the sunitinib clinical
040970 -            study; requires Kaiser approval of payment which would
040971 -            be very cost effective since FNA biopsy at UCSF would
040972 -            cost much less than the more invasive and problematic
040973 -            core biopsy Kaiser has scheduled for Millie on 081113.
040974 -            ref SDS 8 5G5H
040976 -             ..
040977 -            [On 081102 Millie's letter to Doctor Rugo with copy to
040978 -            primary care physician at Kaiser asks how much the FNA
040979 -            biopsy to test for status change will cost at UCSF, and
040980 -            notes this should be less expensive than doing the core
040981 -            biopsy at Kaiser. ref SDS 9 AD3F
040983 -  ..
040984 - The requirement for formalin fixed tissue to test for status change in
040985 - Doctor Daamen's letter today was presented in the doctor's letter
040986 - yesterday on 081023. ref SDS 2 4Q5V
040988 -  ..
040989 - Kaiser's letter continues...
040990 -
040991 -    3.  There is no other HNS MD available to do the repeat FNA or core
040992 -        biopsy on such short notice today other than Dr Wong at
040993 -        11:30am.  Millie can stop by the head and neck surgery office
040994 -        early, but I do not know if he will be able to do the needle
040995 -        earlier than 11:30am.  Please advise if a core needs to be
040996 -        done.
040997 -
040998 -           [...in another record today Millie requested assistance from
040999 -           primary care physician on deciding the type of biopsy to
041000 -           test for status change that expands available treatments for
041001 -           cancer. ref SDS 5 579O
041003 -            ..
041004 -           [On 081024 Millie met with Kaiser Head and Neck Department;
041005 -           decided to perform core biopsy to test for status change,
041006 -           because Kaiser Lab uses different procedures from the lab
041007 -           UCSF uses to check biopsy tissue for status change; Kaiser
041008 -           further decided to defer performing core biopsy work until
041009 -           081107 after Millie returns from vacation to reduce risks of
041010 -           complications cascading out of control without ready access
041011 -           to Kaiser health care while traveling. ref SDS 6 G15K
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