CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS B0 0000. ref SDS A9 0000.
040502 -
040503 -
040504 -
040506 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 -    1.  On 090218 1205 Millie requests explanation of treatment plan.
040902 -        Doctor Rugo's letter to Kaiser on 090129 discussed hyperthermia
040903 -        with Doxil, reported on 090130. ref SDS 64 TZ6H  Has the plan
040904 -        changed to use "lower dose" radiation rather than Doxil.  Will
040905 -        both be used, or some other agent?  At this time, the record is
040906 -        confusing about scope.  Please explain initial assessment, and
040907 -        prognosis.  If this has already been submitted to Doctor
040908 -        Johnson and Doctor Rugo, send a copy to Millie. ref SDS A5 TH5W
040910 -         ..
040911 -    2.  On 090218 1205 Millie reports to medical team good meeting with
040912 -        Doctor Johnson at Kaiser on 090213.  He seemed optimistic that
040913 -        Millie might have 3 - 6 months of recovery, but will need
040914 -        treatment from Doctor Rugo for cancer as a "chronic disease." A
040915 -        week or so ago on 090210, Lena called to scheduling meeting
040916 -        with Doctor Rugo on 090312 0830, reflecting comprehensive
040917 -        follow up ordered by Kaiser during the meeting on 090203.
040918 -        ref SDS A5 TH6U
040920 -         ..
040921 -    3.  On 090218 1205 Millie asks UCSF about obtaining records from Mt
040922 -        Diablo Medical Center of prior radiation in 2002, which Doctor
040923 -        Hsu discussed doing during the meeting at UCSF on 090205.
040924 -        ref SDS 98 PN8H, and which cites Doctor Benz 2nd opinion at
040925 -        UCSF on 041018 saying Millie likely cannot tolerate more
040926 -        radiation. ref SDS 98 YO9G  Was that so long ago, there is risk
040927 -        from additional radiation now? ref SDS A5 TH6X
040929 -         ..
040930 -    4.  On 090218 1205 Millie asks UCSF about responding, ref SDS A5
040931 -        TH7V, to the letter a week ago on 090209 requesting explanation
040932 -        of side effects from radiation and hyperthermia, ref SDS A1
040933 -        745R, following Doctor Hsu's comments during the meeting on
040934 -        090205. ref SDS 98 GM4N  Does the treatment plan address this
040935 -        prospectively, or as needed?  For example, as noted in the
040936 -        letter on 090209, research found that side effects of radiation
040937 -        are sometimes treated with Vitamin E plus pentoxifylline
040938 -        (Trental), ref SDS A1 745R, which can be problematic with
040939 -        Coumadin, so Gloria in the Coagulation Control Clinic at Kaiser
040940 -        will need input. ref SDS A5 TH7V
040942 -         ..
040943 -    5.  On 090218 1205 Millie looking forward to starting treatment on
040944 -        090219, and despite worry about delays that prevent treatment
040945 -        from being effective. ref SDS A5 TH7Y  Millie Thanks Doctor Hsu
040946 -        for expediting care, reported on 090203, ref SDS 84 XX5I, and
040947 -        to Doctor Rugo for guidance through troubled waters, shown by
040948 -        UCSF letter on 090202 1722. ref SDS 79 Y15J
040950 -         ..
040951 -    6.  On 090220 Millie's letter to Doctor Hsu requests...
040952 -
040953 -           a.  Computer file of picture showing typical configuration
040954 -               of hyperthermia treatment. ref SDS A7 XX5O
040955 -
040956 -           b.  Computer file of picture showing typical configuration
040957 -               of radiation treatment. ref SDS A7 XX5O
040959 -                ..
040960 -           c.  Summary/general explanatoin of radiation and
040961 -               hyperthermia treatments.  Radiation on 090219 took much
040962 -               longer than radiation Millie had in 2002, so there seems
040963 -               to be a qualitative difference in technology and
040964 -               process.  Initially assumed IBC in the skin is not
040965 -               treated with radiation, and is directed instead to treat
040966 -               lymphadenopathy.  After today, seems like maybe UCSF is
040967 -               treating IBC with both radiation and hyperthermia??  Can
040968 -               you please clarify. ref SDS A7 EA4Q
040970 -                ..
040971 -           d.  Hyperthermia is a sonar process of some kind.
040972 -               ref SDS A7 EA4T
040974 -                ..
040975 -           e.  Orders for Millie's radiation and hyperthermia
040976 -               treatments, similar to "Chemotherapy Orders" received
040977 -               for treatments in the Infusion Clinic the past 2 years.
040978 -               If possible, UCSF should submit a computer file to
040979 -               reduce the time and cost for adding the treatment plan
040980 -               to patient history. ref SDS A7 EA4W
040982 -                ..
040983 -           f.  Metrics for evaluating when treatment concludes.
040984 -               ref SDS A7 EA5P
040986 -                ..
040987 -               When Millie was treated at Kaiser with capecitabine and
040988 -               Taxotere from Apr - Sep 2005, IBC rash seemed totally
040989 -               resolved by visual examination.  There was then a
040990 -               mastectomy in October 2005.  Biopsy of removed tissue
040991 -               affirmatively reported no findings of IBC.  Yet, years
040992 -               later Millie is being treated again for IBC. ref SDS A7
040993 -               EA5T This raises two questions...
040995 -                    ..
040996 -               1.  How comprehensively can the current treatment
040997 -                   resolve IBC, and how is this assessed, beyond simple
040998 -                   visual inspection, and drop in the cancer marker?
040999 -                   Is there an xray, PET scan, or other diagnostic that
041000 -                   shows where we are for planning follow on steps?
041001 -                   ref SDS A7 EA5T
041003 -                    ..
041004 -               2.  Can hyperthermia treatment be done again, if IBC
041005 -                   pops up later, as obviously happened to me?  Will
041006 -                   there be follow up at least for a month or so in
041007 -                   radiation oncology, in case IBC does recur in the
041008 -                   near term? ref SDS A7 WF5I
041010 -         ..
041011 -    7.  On 090220 0915 Millie radiation and hyperthermia treatment at
041012 -        UCSF. ref SDS A8 0G5I  Millie receivd a copy of notes Chris
041013 -        prepared of a meeting on 090209 with the UCSF medical team on
041014 -        planning Millie's treatment. ref SDS A8 4254
041016 -         ..
041017 -    8.  On 090220 1548 reviewed UCSF memo dated 090209 explaining
041018 -        treatment plan using radiation and hyperthermia for Millie to
041019 -        recover from IBC. ref SDS A9 PR4Y
041021 -         ..
041022 -    9.  On 090220 1548 reviewed BSD paper explaining hyperthermia
041023 -        treatment for recovering from cancer, ref SDS A9 GK6F,
041024 -        including hyperthermia alone...
041025 -
041026 -               hyperthermia................. ref SDS A9 004P
041028 -         ..
041029 -        In combination with....
041030 -
041031 -               radiation.................... ref SDS A9 TT6L
041032 -               chemotherapy................. ref SDS A9 0129
041033 -               biological vaccines.......... ref SDS A9 0164
041035 -         ..
041036 -   10.  On 090223 0237 Millie's letter to medical team....
041037 -
041038 -            a.  Thanks UCSF for submitting memo dated 090209 on
041039 -                planning hyperthermia treatments. ref SDS B0 T47U
041041 -                 ..
041042 -            b.  Requests work plan for radiation treatments.
041043 -                ref SDS B0 3N9J and ref SDS B0 T49U, similar to work
041044 -                plan for hyperthermia.
041045 -
041046 -                    [...below, Chris reports investigating to get the
041047 -                    work plan for radiation. ref SDS 0 PR4Y
041049 -                 ..
041050 -            c.  Notes clinical findings that swelled lymph node in left
041051 -                supraclavicular occurred again, ref SDS B0 T48S, and
041052 -                asks if this will be radiated, and what other areas
041053 -                will be radiated. ref SDS B0 T49R
041055 -                 ..
041056 -            d.  Reports upper left arm looks worse than before
041057 -                treatment started, asks if this is expected side
041058 -                effects of radiation and hyperthermia treatment.
041059 -                ref SDS B0 T49Y
041061 -                 ..
041062 -            e.  Reports Cellulitis and lymphadema have been continuing
041063 -                problems on left arm, ref SDS B0 T44R, asks if Keflex
041064 -                should be started to prevent recurrence caused by
041065 -                treatment for IBC? ref SDS B0 T44W
041067 -                 ..
041068 -            f.  Requests picture of Millie getting hyperthermia
041069 -                treatment showing configuration of work process.
041070 -                ref SDS B0 T45S
041071 -
041072 -                    [...below, Chris sumbits the picture. ref SDS 0
041073 -                    GZ4H
041074 -
041075 -
041076 -
041077 -
041078 -
0411 -

SUBJECTS
Spec Medical Physics Hyperthermia with  Rdiation Strategy Treatment

1503 -
150401 -  ..
150402 - Radiation Treatment UCSF Investigates to Locate Plan
150403 - Treatment Strategy Hyperthermia and Lower Dose Radiation
150404 -
150405 - Follow up ref SDS B0 PR4Y, ref SDS A9 PR4Y.
150406 -
150407 - Millie received a letter from Chris sent today responding to Millie's
150408 - letter sent earlier this morning, ref SDS B0 3H7H,
150409 -
150410 -    1.  Subject:  Hyperthermia Radiation Treatment Plan Pending
150411 -        Date: Mon, 23 Feb 2009 08:18:16 -0800
150418 -
150419 -        [...responding to your letter this morning 090223, ref SDS B0
150420 -        3H7H]
150422 -         ..
150423 -        I do not have access to print out the radiation plan [requested
150424 -        in Millie's letter this morning on 090223 0237, ref SDS B0
150425 -        3N9J, I will look into this and also ask Dr.  Hsu to do so when
150426 -        he gets a chance.
150427 -
150428 -           [On 090226 1342 Millie received radiation treatment plan
150429 -           that complements hyperthermia plan for Millie to recover
150430 -           from IBC. ref SDS B1 PR4Y
150431 -
150432 -
150437 -
150439 -  ..
150440 - Picture Configuration Hyperthermia Treatment Recover from IBC at UCSF
150441 -
150442 - Later in the afternoon, received a second letter from Chris that has
150443 - the picture of the configuration for getting hyperthernmia treatment
150444 - at UCSF...
150445 -
150446 -                 
150447 -
150448 -
150449 -
150450 -
150451 -
150452 -
150453 -
150454 -
1505 -