CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 22 0000. ref SDS 21 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - On 081016 Doctor Rugo ordered a biopsy of left supraclavicular to test
040902 - for progression of disease that requires changing Millie's treatment.
040903 - The order also specified that the biopsy would test for status change.
040904 - ref SDS 7 J36R  The sunitinib clinical study documents did not discuss
040905 - triple negative requirements. ref SDS 7 J44R  In a letter on 081017
040906 - the doctor indicated the study is not for triple negative alone.
040907 - ref SDS 8 6J3T  Background on status change in Millie's patient listed
040908 - on 081016 shows status change can have a "huge" impact increasing
040909 - treatments for Millie. ref SDS 7 PP9J
040911 -  ..
040912 - Kaiser performed the FNA biopsy on 081022. ref SDS 10 NZ5N  The next
040913 - day, Kaiser reported the test was positive for cancer, and that
040914 - testing for status failed, because FNA biopsy did not extract enough
040915 - tissue.  Kaiser proposed doing a core biopsy, and asked if this is
040916 - necessary for Millie. ref SDS 12 4Q9Q  On 081024 Millie met with
040917 - Doctor Wong at Kaiser Head and Neck to perform the core biopsy.  The
040918 - doctor reviewed patient history and advised that core biopsy is risky.
040919 - ref SDS 13 W183  The core biopsy was deferred until Millie returns
040920 - from vacation on 081107.  On 081027 Kaiser called and delayed the core
040921 - biopsy to test for status again until 081117. ref SDS 14 G15K
040923 -  ..
040924 - Millie notified UCSF on 081027 that the test for status change was
040925 - delayed again until 081117, and asked if this would delay getting
040926 - treatment for cancer. ref SDS 15 R79W  Glenna called and indicated
040927 - Doctor Rugo would be asked about the core biopsy for status change
040928 - issue. ref SDS 16 934O  On 081029 Millie sent a letter transmitting
040929 - the updated work plan to the medical team and discusses doing FNA
040930 - biopsy for status check at UCSF in order to reduce the risks of core
040931 - biopsy at Kaiser. ref SDS 17 C49U
040933 -  ..
040934 - Millie's follow up letter to UCSF early today on 081031 with copy to
040935 - Kaiser asks about doing FNA biopsy at UCSF. ref SDS 19 NN5S  Glenna
040936 - called later in the day today on 081031 and disclosed that testing
040937 - status change is not required for the sunitinib clinical study.
040938 - Glenna further indicated this is a controversial issue, which she
040939 - cannot help coordinate.  Glenna indicated Millie should contact Doctor
040940 - Rugo about following up the order for an FNA biopsy to test for status
040941 - change. ref SDS 21 T27H
040943 -  ..
040944 - Glenna's letter today confirming her call on the UCSF schedule for
040945 - Millie to start treatment on 081113 does not mention pending core and
040946 - FNA biopsy issue to test status change. ref SDS 22 5G5H
040948 -  ..
040949 - Millie submitted a letter to Doctor Rugo with a copy to Doctor Johnson
040950 - at Kaiser, and a copy to Glenna showing implementation of Glenna's
040951 - letter earlier today. ref SDS 22 5G5H
040952 -
040953 -    1.  Subject: Sunitinib Start Nov 13th Meeting Doctor Rugo
040954 -        Date: Fri, 31 Oct 2008 19:09:15 -0700
040962 -         ..
040963 -    2.  Thanks for excellent work by Glenna at UCSF, and Doctor Johnson
040964 -        at Kaiser on maintaining continuity of treatment for my 5th
040965 -        relapse of IBC [shown in Glenna's letter today on 081031,
040966 -        ref SDS 22 SI9U].
040968 -         ..
040969 -    3.  Glenna's letter today shows everything in the work plan is set
040970 -        for treatment to  start on 081113 (Nov 13). ref SDS 22 SJ3W
040971 -        This implements Doctor Rugo's direction on 081016, ref SDS 7
040972 -        J36R, to use the prior schedule for comprehensive care
040973 -        transitioning to new treatment. ref SDS 7 N99W
040975 -         ..
040976 -    4.  I meet with Glenna next week Friday at UCSF on 081107 to sign
040977 -        consent documents, and get labs in the Infusion Clinic on the
040978 -        5th floor, ref SDS 22 SI4X, following practice for the past 2
040979 -        years.
040981 -         ..
040982 -    5.  I meet with Doctor Rugo a week later on 081113 0830 for study
040983 -        orientation, examination, and then start treatment that day.
040985 -         ..
040986 -    6.  Should we schedule FNA biopsy for status change at UCSF, since
040987 -        Doctor Wong says Kaiser requires a core biopsy and FNA biopsy
040988 -        supported by UCSF is less risky, reported on 081024.
040989 -        ref SDS 13 KE6J
040991 -  ..
040992 - Doctor Daamen cautioned in a letter to the medical team on 081023
040993 - about risk of core biopsy to Millie's patient profile by asking if
040994 - this is necessary. ref SDS 12 4Q5V
040995 -
040996 -               [On 081101 Doctor Rugo says FNA biopsy to check for
040997 -               status change is not part of the sunitinib clinical
040998 -               study; requires Kaiser approval of payment which would
040999 -               be very cost effective since FNA biopsy at UCSF would
041000 -               cost much less than the more invasive and problematic
041001 -               core biopsy Kaiser has scheduled for Millie on 081113.
041002 -               ref SDS 23 5G5H
041004 -                ..
041005 -               [On 081102 Millie's letter to Doctor Rugo with copy to
041006 -               primary care physician at Kaiser asks how much the FNA
041007 -               biopsy to test for status change will cost at UCSF, and
041008 -               notes this should be less expensive than doing the core
041009 -               biopsy at Kaiser. ref SDS 24 AD3F
041011 -  ..
041012 - Doctor Shim reported in a letter on 050909 from the Surgery Department
041013 - at Kaiser in Oakland that biopsy to test for status change is
041014 - necessary to have a huge impact increasing treatment options for
041015 - Millie. ref SDS 1 JX9P
041017 -  ..
041018 - Millie's letter to UCSF and Kaiser continues...
041019 -
041020 -    7.  Doctor Wong noted the punch biopsy on 040419 took over a year
041021 -        to heal. ref SDS 13 DU4L  He seemed to indicate that core
041022 -        biopsy is more invasive. ref SDS 13 7M57  If FNA biopsy is less
041023 -        risky, then possibly FNA biopsy can be done at UCSF, when I
041024 -        meet with Glenna next week on 081107?  Evidently, now that we
041025 -        have a positive node, this is a good time to evaluate status
041026 -        change.
041028 -         ..
041029 -    8.  Any thoughts?
041030 -
041038 -
041039 -
041040 -
041041 -
041042 -
041043 -
0411 -