CONTACTS 

SUBJECTS
Phase I Care Cancer Hodgkin's Lymphoma Stage 4 Chemotherapy 101105 K

3103 -
3103 -    ..
3104 - Summary/Objective
3105 -
310501 - Follow up ref SDS 17 0000. ref SDS 15 0000.
310502 -
310503 -
310504 -
310505 -
310507 -  ..
3106 -
3107 -
3108 - Progress
3109 -
310901 - Pam advised that Ron was diagnosed stage 4 Hodgkin's lymphoma, which
310902 - aligns with Pam's letter to Peggy reported on 101105 1632. ref SDS 17
310903 - CU30  Has edema in one arm, similar to his mom whose left arm was
310904 - swollen for years with lymphedema.  Ron also has kidney problems.
310906 -  ..
310907 - Ron received first chemotherapy treatment on Friday, 101105.  Pam saw
310908 - him the next day on Saturday, and nearly cried, because side effects
310909 - are hard to tolerate.  Pam talked to Kim, and she reported he was
310910 - doing better the next day on Sunday using a walker to get around out
310911 - of bed.
310912 -
310913 -            [On 101118 1741 Ron scheduled for PET test on 101119,
310914 -            ref SDS 25 YR6J, may get 2nd chemo treatment in the cycle.
310915 -            ref SDS 25 OP68
310917 -  ..
310918 - Kim went to work today.  Pam is running errands this afternoon.  She
310919 - will swing by the hospital to see how her brother is doing.  The
310920 - doctors are planning to discharge Ron for home care by the end of the
310921 - week.
310922 -
310923 -            [On 101115 0842 letter asks Pam if Ron Junior was
310924 -            discharged from hospital at John Muir to go home as
310925 -            planned? ref SDS 22 6K8P
310927 -  ..
310928 - Kim has indicated that Ron is being treated with a "coctail" of 4
310929 - drugs with 2 treatments in a 28 day cycle, which sounds like treatment
310930 - every 2 weeks.  He at least gets time to recover and have some good
310931 - days before being hit again.
310932 -
310933 -            [On 101118 1741 Ron scheduled for PET test on 101119,
310934 -            ref SDS 25 YR6J, may get 2nd chemo treatment in the cycle.
310935 -            ref SDS 25 OP68
310937 -  ..
310938 - Wikipedia lists a common first-line treatment for Hodgkin's lymphoma
310939 - occurs with ABVD regimen...
310940 -
310941 -        Adriamycin (duxorubicin)
310942 -        bleomycin
310943 -        vinblastine
310944 -        dacarbazine
310946 -  ..
310947 - Another source seems to indicate that for advanced Hodgkin's lymphoma,
310948 - cyclophosphamide is also used with Adriamycin.
310950 -  ..
310951 - The family might want to notify Ron's medical team that his mom was
310952 - treated with AC twice, and both times it was ineffective; she received
310953 - cyclophosphamide a 3rd time, and it was again ineffective, shown in
310954 - Mil's treatment history listed on 090213 1140. ref SDS 6 AC6G  Common
310955 - genetics between mother and son may impact Ron's treatment.
310957 -  ..
310958 - Research indicates side effects can be difficult to tolerate.
310960 -  ..
310961 - One soucrce which could be access directly talked about....
310962 -
310963 -                six 28-day cycles
310965 -  ..
310966 - This is 6 months.
310968 -  ..
310969 - Helping Ron get through 6 months of difficult side effects will be a
310970 - big challenge, cited in a letter to Peggy on 101106 1533. ref SDS 19
310971 - UY8H
310972 -
310973 -
310975 -  ..
3110 -
3111 -
3112 - 2243
3113 -
311301 - Sent letter to Pam saying...
311302 -
311303 -    1.  Subject: Thanks for Calling Today
311304 -        Date: Mon, 08 Nov 2010 23:36:28 -0800
311311 -         ..
311312 -    2.  Very sorry to hear Ron is not home yet.  Sounds like he has 2
311313 -        weeks between treatments to recover and have some "good days"
311314 -        to enjoy. ref SDS 0 XR5H  Having family near helps maintain
311315 -        resolve for treatment to be effective.  He and Kim have a lot
311316 -        of complications ahead.  Has anyone asked if there is a
311317 -        "targeted" treatment for Ron that does not have bad side
311318 -        effects of chemo?
311320 -         ..
311321 -    3.  Adriamycin and cyclophosphamide (more commonly "Cytoxan") are
311322 -        treatments for advanced Hodgkin's lymphoma in various
311323 -        "cocktail" regimens (e.g., ABVD), which you mentioned today.
311324 -        If Ron is getting these drugs, the medical team should know
311325 -        that his mom received AC, and she got worse (cancer marker
311326 -        increased from 80 to over 120, when it should have gone down),
311327 -        so Kaiser switched to Taxotere after the 1st cycle.  Genetic
311328 -        histology can influence treatment, and sometimes not, so maybe
311329 -        Mil's experience is not important in this case.  Discussion in
311330 -        the doctor/patient partnership might be helpful.
311331 -
311332 -            [On 101115 0842 letter asks Pam if Ron Junior was
311333 -            discharged from hospital at John Muir to go home as
311334 -            planned? ref SDS 22 6K8P
311336 -         ..
311337 -    4.  Thanks very much for notice in your letter on Nov 2nd, of a
311338 -        seminar this weekend on records management.  There are a lot of
311339 -        good systems used at PG&E, Kaiser, DOD, Enron, AIG, Bear
311340 -        sterns, UCSF, indeed everywhere.  Since as you say "two heads
311341 -        are better than one," I'm glad to have "your head" giving
311342 -        thought to my work.
311344 -         ..
311345 -    5.  Ross and Claudia called yesterday and invited me for
311346 -        Thanksgiving.  Would be gone for a week, maybe 2.  Leave Monday
311347 -        or Tuesday, and return following Tuesday or Wednesday to miss
311348 -        the holiday rush.  Could you look in on Sasha?  She is doing
311349 -        really well now.  If Janet next door can feed her, it would
311350 -        still be helpful for you to check on things once or twice a
311351 -        week, when convenient.
311352 -
311353 -            [On 101109 1104 Pam responds she can check on Sasha during
311354 -            weekends. ref SDS 20 XR5H
311356 -             ..
311357 -            [On 101110 2013 received letter from Ross transmitting
311358 -            flight information, including Internet access to buy
311359 -            tickets online. ref SDS 21 HH8P  Ordered tickets from
311360 -            Virgin America airlines, reported 101110 2013 at 2049
311361 -            ref SDS 21 4Q4T
311363 -             ..
311364 -            [On 101116 1220 letter to Janet asking if she can help with
311365 -            feeding Sasha during Thanksgiving week. ref SDS 23 DN8Q
311367 -             ..
311368 -            [On 101116 1220 at 1332 Janet will be out of town also for
311369 -            Thanksgiving and so cannot care for Sasha. ref SDS 23 4P4J
311371 -             ..
311372 -            [On 101116 1450 letter asks Arlette if she can watch Sasha
311373 -            during the trip to New York. ref SDS 24 6G5L
311375 -             ..
311376 -            [On 101116 1450 at 1703 Arlette will take care of Sasha for
311377 -            trip to New York during Thanksgiving week. ref SDS 24 FK4K
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