May 15, 2013 - 8:54 am
Well, I am home from Hallwang and will report all that happened and will be happening below:
First off, I will start with my pre-treatment bloodwork. Everything was pretty normal, even with my liver which has the biliary stent with bilirubin at 0.5 (normal is 0.1-1.2), Alk Phos enzymes a little high, other enzymes normal or just a few percent high, and blood counts all pretty much normal. CEA was 4.2 (normal and down from 5.7 at diagnosis) and CA19-9 was 69 I believe (don't have the numbers in front of me). The RGCC testing indicated my tumors should be susceptible to platinum drugs (oxy, cis and carbo), 5FU, irinotecan, and a couple of other chemo drugs (mitimycin C and bendastumine). However, I had very high expression of a gene called MDR-1 which stands for multi-drug resistance, so my tumor has high potential for becoming resistant to drugs. My tumor also showed very high expression of invasiveness potential (metastasis), angiogenesis (creating new blood vessels to feed it), and high expression of EGF (KRAS mutant so not unexpected) as well as RAS (might be a good candidate for treatment with a virus in clinical trials from a company called Oncolytics which targets cells with a RAS mutation and kills them). My total cholesterol was a bit high at 210, but my HDL (good cholesterol) was 70 which was well above the recommended 45 limit. Also, my tumor had over-expression of insulin like growth factor, which means it is very good at taking up glucose.
Now to the treatments. I received one chemo embolization of the liver by Dr. Vogl where he injected mitomycin C, irinotecan and avastin directly into the liver, which was followed the next day by whole body hyperthermia. After that, I had to wait for my RGCC results, so I did immune boosting infusions for about 8-9 days before my first removab. Note: If at all possible, get your RGCC testing done before you arrive at Hallwang and it will save you lots of money! I did 2 removab treatments (5ug and then 10ug) but could not get in a 3rd removab or 2nd Vogl before leaving due to my liver not returning to normal quick enough, but Dr. Kopic said that my 2 treatments appearedto work very well. I also received an antiviral treatment, as my CTCs (circulating tumor cells) showed infection with HHV2 (herpes virus 2) and HPV16 (human papilloma virus). Treatment included daily infusions as well as daily pills. The removab treatment caused me high fever and weakness for 1-2 days, starting 3-4 hours after infusion began.
Finally, I was sent home with a suitcase full of supplements (based on RGCC testing) as well as metformin to lower glucose, and was also instructed to go back on low dose Xeloda (1000mg/day) and also to go back on avastin. Dr. Kopic recommended getting CT scans in 6-8 weeks to see how well the tumors responded to the treatment. If I see positive results, I will likely go back in late-August for more removab and chemo embolization treatments, but will do it as cheaply as possible. Total cost for my 4 week stay was about 48k euros. I think I can go back and do another treatment for under 30k euros.