We left the house this morning at 5:00 am and drove to Boston for an 11:00 am Ultrasound. Surgery was to follow. The ultrasound went off on time, we had the wait 3.5 hours for the interventional radiology to perform te Abdomen tap surgery. Both kids were really well behaved considering they hadn't eaten anything since the night before, road five hours in the car and then placed in a procedure room for 4 hours.
Jack did have significant fluid in his abdomen again, more so than last time. So they proceeded with the tap and they drained off 2,160 cc's if fluid over and hour and half procedure. This is about 600 cc more than last time and is equivalent to a whole 2 litre bottle extra in his little belly area.
They said he did really well; rock steady vitals, he woke up great out of general and started eating a popsicle and asking to eat.
We finished up a Dana Farber with a weight and belly measurement and got cleared to leave. Did't have the energy to drive home tonight so we will stay at the RMH in Boston and leave tomorrow.
The plan is to hopefully not have any more excessive fluid and then start a new Chemo protocol a week from Friday. We have decided on a two chemo regiment that is Irinotecan (spelling) and Avastin (Bevaizumab).
Irinotecan is a chemotherapy drug made from a type of plant alkaloid known as a topoisomerase I inhibitor. It is thought to work by blocking the action of an enzyme in cells called topoisomerase I. Cells need this enzyme to keep their DNA in the proper shape when they are dividing into 2 cells. Blocking this enzyme leads to breaks in the DNA, which leads to cell death. Because cancer cells divide faster than normal cells, they are more likely than normal cells to be affected by irinotecan.
Bevacizumab is a type of targeted therapy known as a monoclonal antibody. A monoclonal antibody is a man-made version of an immune system protein that fits like a lock and key with a certain protein in the body.
Bevacizumab attaches to a protein called vascular endothelial growth factor (VEGF), which is required by the body to grow blood vessels. It is thought that by doing this, the drug stops tumors from being able to create new blood vessels to feed the tumor. This limits the tumors' supply of nutrients, which in turn may slow or stop their growth. For this reason, bevacizumab is sometimes referred to as an anti-angiogenic drug. Another theory is that it may help by making tumor blood vessels (which are usually leaky) more stable, allowing chemotherapy to get into cancer cells more effectively.
We march forward.