THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rodwelch@pacbell.net
S U M M A R Y
DIARY: March 23, 2009 01:52 PM Monday;
Rod Welch
Called Kaiser to get report CA 15-3 251 shows response to treatment for
blood test on 090317 corrects mistake from labs on 090309.
1...Summary/Objective
..............
Click here to comment!
CONTACTS
SUBJECTS
Default Null Subject Account for Blank Record
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS B9 0000. ref SDS B7 0000.
040502 -
040503 -
040504 -
040505 -
040507 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - 1. On 090213 the doctor ordered labs for Millie at Kaiser on
040902 - 090309 to evaluate progress with treatments at UCSF for cancer.
040903 - ref SDS B0 IW68
040905 - ..
040906 - 2. On 090309 Millie went to Kaiser and blood was drawn for the
040907 - lab. ref SDS B2 6Z4F
040909 - ..
040910 - 3. On 090310 Millie's letter to the medical team requested report
040911 - for blood test on 090309 to support the meeting at UCSF need CA
040912 - 15-3 as only objective metric on progress responding to
040913 - treatment. ref SDS B3 O63T
040915 - ..
040916 - 4. On 090311 Millie went to Kaiser and received a copy of the
040917 - report for the blood test on 090309. ref SDS B4 CV83 The report
040918 - received from Kaiser on 090311 did not include CA 15-3.
040919 - ref SDS B4 CV9M
040921 - ..
040922 - 5. On 090312 Millie met with the medical team at UCSF and
040923 - submitted the report for the blood test on 090309. ref SDS B2
040924 - S65I Tara entered this in the UCSF medical chart. ref SDS B5
040925 - 337K She said that evaluation of resonse to treatment is
040926 - difficult without CA 15-3, because IBC symptoms are similar to
040927 - side effects of radiation and hyperthermia treatments.
040928 - ref SDS B5 YX5F
040930 - ..
040931 - 6. On 090312 called Kaiser and learned mistake ordering blood
040932 - tests computer shows CA 15-3 was not included in order for labs
040933 - on 090309. ref SDS B6 SV8M
040935 - ..
040936 - 7. On 090313 called Arlette. She planned to ask Doctor Johnson
040937 - about CA 15-3, ref SDS B7 3R7J, results for the blood test at
040938 - Kasier on 090309. ref SDS B2 S65I
040940 - ..
040941 - 8. On 090317 1120 called Kaiser and talked to Arlette; hectic
040942 - schedule on 090313 prevented following up on plans to discuss
040943 - CA 15-3 results for blood test on 090309. ref SDS B9 Y077
040945 - ..
040946 - 9. On 090317 1120 Arlette ordered make up blood draw to test CA
040947 - 15-3. ref SDS B9 YP6S
040949 - ..
040950 - 10. On 090317 1120 Millie went to Kaiser on the way home from
040951 - treatment at UCSF and got another blood draw to test CA 15-3.
040952 - ref SDS B9 PQ6R
040953 -
040954 -
040955 -
0410 -
SUBJECTS
Default Null Subject Account for Blank Record
0503 -
050401 - ..
050402 - Connie called with results of Millie's blood test on 090317 for the
050403 - cancer marker CA 15-3 251, ref SDS B9 PQ6R, to correct omission in
050404 - Millie's lab on 090309, ref SDS B2 PQTQ, which was cited during
050405 - examination at UCSF on 090312. ref SDS B5 337K, and prevented accurate
050406 - assessment of response to treatment. ref SDS B5 YX5F
050408 - ..
050409 - Connie noted with great delight that Millie has a significant 50 point
050410 - drop in the cancer marker for the prior lab at Kaiser that tested CA
050411 - 15-3 303 for the blood draw on 090116. ref SDS A6 A16M
050413 - ..
050414 - Millie's letter to medical team on 090310 considered scenarios of
050415 - rising, stable, and declining cancer marker for evaluating response to
050416 - treatment. ref SDS B3 O64T
050418 - ..
050419 - Net decline of 54 points (305 - 251) in the cancer marker today seems
050420 - to support examination in the Breast Care Clinic at UCSF on 090312
050421 - finding response to treatement. ref SDS B5 337K Similar favorable
050422 - assessment in the Radiation Oncology Department also on 090312,
050423 - ref SDS B5 H68O, also supported by declining cancer marker reported
050424 - today, and effective on 090317, the day Millie's treatments ended at
050425 - UCSF.
050427 - ..
050428 - Decline of 54 points from CA 15-3 305 on 090116 at Kaiser labs likely
050429 - represents a much larger improvement, because Millie's IBC was rising
050430 - rapidly during the 3 weeks after treatment with sunitinib was ended on
050431 - 090122. illustrated by sudden increase of 14 points after months of
050432 - stability in cancer marker calculated by the UCSF labs, and during 3
050433 - weeks from 090108 to 090129. (see study below, ref SDS 0 J13O)
050434 -
050435 - [On 090325 0830 Doctor Johnson seems to concur with analysis
050436 - today that cancer marker declined much more significantly based
050437 - on rising trajectory from 090116 until the start of Millie's
050438 - treatment on 090219. ref SDS C0 WU5O
050440 - ..
050441 - If the cancer burden as measured by Kaiser labs continued to rise at
050442 - the same rate during the period from 090116 until the start of
050443 - treatment 5 weeks later with radiation and hyperthermia on 090219, as
050444 - occurred during the 3 weeks between 081226 and 090116 that would be
050445 - approximately...
050446 -
050447 - 090116 - 091226 = 21 days
050449 - ..
050450 - 305 - 202 = 103 / 21 = 5 points rise per day.
050451 -
050452 - 090219 - 090116 = 34 days
050453 -
050454 - 5 x 34 days = 170
050456 - ..
050457 - 305 + 170 = 475
050459 - ..
050460 - 475 - 251 = 224 calculated minimal improvement
050462 - ..
050463 - It seems likely that the cancer marker was accelerating rather than
050464 - increasing at a steady rate during the 4 weeks Millie did not get
050465 - treatment, so CA 15-3 diagnostic could have climbed to 500 or even
050466 - above 1000, until treatment started on 090219, based on Doctor Rugo's
050467 - letter on 090202 notifying the medical team that Millie needs urgent
050468 - treatment quickly to stop the spread of IBC disease. ref SDS A9 Y15J
050470 - ..
050471 - The critical factor will be the next test to assess continued recovery
050472 - toward cancer marker targets (39 at Kaiser), and based on Doctor Hsu's
050473 - explanation at UCSF on 090312 that patients continue to get theraputic
050474 - benefits recovering from cancer for weeks and even months after
050475 - radiation and hyperthermia ends. ref SDS B5 VL4O
050477 - ..
050478 - Patient history on CA 15-3 and treatments....
050479 -
050480 - Kaiser = K---|
050481 - UCSF = U---|
050482 - Test Date Date Received
050483 - 100622........1116 H K.............. 100622, ref SDS D6 L54I
050484 - 100529........ 606 H K.............. 100606, ref SDS D5 8H5I
050485 - 100511........ 520 H K.............. 100511, ref SDS D4 L54I
050486 - 100426........ 424 H K.............. 100428, ref SDS D3 QX4O
050487 - 100413........ 367 H K.............. 100414, ref SDS D2 683K
050488 - 100329........ 384 H K.............. 100331, ref SDS D1 GE5F
050489 - 100316........ 369 H K.............. 100319, ref SDS D0 1T3Y
050490 - 100303....Abraxane begins........... 100303, ref SDS C9 625I
050491 - 100301........ 426 H K.............. 100301,
050492 - 100216........ 328 H K.............. 100217,
050493 - 100202........ 275 H K.............. 100202,
050494 - 100112....treatment paused 3 weeks.. 100112,
050495 - 100111........ 212 H K.............. 100111,
050496 - 091222........ 248 H K.............. 091222,
050497 - 091215........ 211 H K.............. 091215,
050498 - 091124........ 262 H K.............. 091215,
050499 - 091116....Navelbine begins.......... 091118, ref SDS C8 625I
050500 - 091103........ 299 H K..............
050501 - 091020........ 299 H K..............
050502 - 091006........ 343 H K..............
050503 - 090929........ 297 H K..............
050504 - 090921........ 302 H K..............
050505 - 090908........ 346 H K.............. 090908,
050506 - 090825........ 335 H K.............. 090825,
050507 - 090810........ 350 H K..............
050508 - 090728....Gemzar begins............. 090728, ref SDS C7 W65H
050509 - 090727........ 389 H K...........
050510 - 090716....MPA ends.................. 090716, ref SDS C6 YG8P
050511 - 090716........ 193 H U.............. 090716, ref SDS C5 A16M
050512 - 090616....MPA begin................. 090616, ref SDS C4 YO4J
050513 - 090602........ 289 H K.............. 090602, ref SDS C3 PQTQ
050514 - 090512........ 320 H K.............. 090512, ref SDS C2 PQTQ
050515 - 090413........ 271 H K.............. 090413, ref SDS C1 PQTQ
050516 - 090317........ 251 H K.............. 090323, ref SDS 0 Y077
050517 - 090317...rad hyprthmia end.......... 090317, ref SDS B8 9L7K
050518 - 090219...rad hyprthmia begin........ 090219, ref SDS B1 E57G
050519 - 090129........ 113 H U.............. 090129, ref SDS A8 A16M
050520 - 090122...sunitinib end.............. 090122, ref SDS A7 AT6N
050521 - 090116........ 303 H K.............. 090116, ref SDS A6 A16M
050522 - 090108......... 99 H U.............. 090108, ref SDS A5 A16M
050523 - 081218......... 95 H U.............. 081218, ref SDS A3 A16M
050524 - 081226........ 202 H K.............. 081226, ref SDS A4 A16M
050525 - 081210........ 197 H K.............. 081210, ref SDS A2 A16M
050526 - 081126........ 105 H U.............. 081126, ref SDS A1 A16M
050527 - 081114...sunitinib begin............ 081114, ref SDS A0 505G
050528 - 081023...cetuximab Carbo ends....... 081023, ref SDS 99 D65G
050529 - 081016........ 95 H U.............. 081016, ref SDS 98 A16M
050530 - 080918........ 95 H U.............. 080918, ref SDS 97 A16M
050531 - 080821........ 96 H U.............. 080821, ref SDS 96 A16M
050532 - 080918......... 95 H U.............. 080918, ref SDS 97 VK6H
050533 - 080821......... 96 H U.............. 080821, ref SDS 96 VK6H
050534 - 080724......... 71 H U.............. 080724, ref SDS 95 TR4K
050535 - 080708.........141 H K.............. 080708, ref SDS 94 L74K
050536 - 080626......... 72 H U.............. 080626, ref SDS 93 PW7I
050537 - 080529......... 66 H U.............. 080529, ref SDS 92 IJ8L
050538 - 080501......... 59 H U.............. 080501, ref SDS 91 U34O
050539 - 080403......... 66 H U.............. 080403, ref SDS 90 A16M
050540 - 080313...cetuximab Carboplatin...... 080313, ref SDS 89 TZ8I
050541 - 080306......... 59 H U.............. 080306, ref SDS 88 A16M
050542 - 080207......... 63 H U.............. 080207, ref SDS 87 A16M
050543 - 080110......... 51 H U.............. 080110, ref SDS 86 A16M
050544 - 071213......... 48 H U.............. 071213, ref SDS 85 A16M
050545 - 071115......... 43 H U.............. 071115, ref SDS 84 A16M
050546 - 071018......... 75 H K.............. 071018, ref SDS 83 5K6K
050547 - 070920......... 38 H U.............. 070920, ref SDS 82 A16M
050548 - 070816......... 28 H U.............. 070816, ref SDS 81 A16M
050549 - 070719...**.... ?? H U.............. 070719, ref SDS 80 A16M
050550 - 070621......... 30 H U.............. 070621, ref SDS 79 A16M
050551 - 070524......... 37 H U.............. 070524, ref SDS 78 A16M
050552 - 070511......... 56 H K.............. 070516, ref SDS 77 RH9H
050553 - 070426......... 29 ..U.............. 070426, ref SDS 76 A16M
050554 - 070329......... 33 H U.............. 070406, ref SDS 75 EQ6I
050555 - 070301......... 36 H U.............. 070307, ref SDS 74 A16M
050556 - 070215......... 52 H K.............. 070307, ref SDS 73 ER5O
050557 - 070208......... 55 H K.............. 070307, ref SDS 73 ER5O
050558 - 070201...cetuximab begin............ 070201, ref SDS 71 G68I
050559 - 070131......... 56 H K.............. 070202, ref SDS 72 087J
050560 - 070123......... 52 H K.............. 070202, ref SDS 72 087J
050561 - 070118......... 68 H K.............. 070123, ref SDS 70 GK5B
050562 - 070104......... 56 H K.............. 070110, ref SDS 69 087J
050563 - 061218......... 74 H K.............. 061227, ref SDS 68 6P9F
050564 - 061214......... 63 H................ 061227, ref SDS 68 6P9F
050565 - 061130....capecitabine Taxotere.end. 061201, ref SDS 67 ZZ9N
050566 - 061130......... 67 H................ 061201, ref SDS 67 087J
050567 - 061116......... 66 H................ 061201, ref SDS 67 087J
050568 - 061110......... 56 H................ 061201, ref SDS 67 087J
050569 - 061109......... 61 H................ 061110, ref SDS 66 087J
050570 - 061026......... 57 H................ 061110, ref SDS 66 087J
050571 - 061019......... 56 H................ 061020, ref SDS 65 087J
050572 - 060928......... 51 H................ 060929, ref SDS 64 087J
050573 - 060907......... 68 H................ 060929, ref SDS 64 087J
050574 - 060813......... 73 H................ 060817, ref SDS 63 U24M
050575 - 060809......... 87 H................ 060810, ref SDS 62 2N5J
050576 - 060721....capecitabine Taxotere..... 060721, ref SDS 61 0001
050577 - 060708......... 71 H................ 060711, ref SDS 60 087J
050578 - 060616......... 63 H................ 060623, ref SDS 59 UQ5Q
050579 - 060522......... 59 H................ 060605, ref SDS 58 UQ5Q
050580 - 060501......... 49 H................ 060522, ref SDS 57 MC4F
050581 - 060421......... 44 H................ 060428, ref SDS 56 087J
050582 - 060330......... 40 H................ 060428, ref SDS 56 087J
050583 - 060303......... 36.................. 060428, ref SDS 56 087J
050584 - 060210......... 33.................. 060217, ref SDS 55 087J
050585 - 060109......... 34.................. 060126, ref SDS 54 KV59
050586 - 051223......... 34.................. 060106, ref SDS 53 087J
050587 - 051202....**... 28.................. 060106, ref SDS 53 087J
050588 - 051116......... 31.................. 051121, ref SDS 52 087J
050589 - 051109......... 30.................. 051121, ref SDS 52 087J
050590 - 051102......... 34.................. 051121, ref SDS 52 087J
050591 - 051021....Mastectomy surgery........ 051021, ref SDS 51 0001
050592 - 050916....capecitabine Taxotere end. 050916, ref SDS 49 407N
050593 - 050909......... 45 H................ 051007, ref SDS 50 087J
050594 - 050826......... 45 H................ 050913, ref SDS 48 087J
050595 - 050819......... 45 H................ 050913, ref SDS 48 087J
050596 - 050812......... 39 ................. 050819, ref SDS 47 3K6L
050597 - 050729......... 45 H................ 050819, ref SDS 47 EA5G
050598 - 050708......... 46 H................ 050729, ref SDS 46 087J
050599 - 050701......... 37 ................. 050708, ref SDS 45 2N5J
050600 - 050617......... 45 H................ 050729, ref SDS 46 087J
050601 - 050527......... 56 H................ 050610, ref SDS 44 087J
050602 - 050512......... 67 H................ 050520, ref SDS 43 087J
050603 - 050506......... 80 H................ 050520, ref SDS 43 087J
050604 - 050415.........105 H................ 050422, ref SDS 42 087J
050605 - 050415....capecitabine Taxotere..... 050329, ref SDS 41 AW5G
050606 - 050329....AC ends................... 050329, ref SDS 41 AW5G
050607 - 050325.........100 H................ 050329, ref SDS 41 087J
050608 - 050318.........101 H................ 050325, ref SDS 40 2N5J
050609 - 050304......... 88 H................ 050311, ref SDS 39 087J
050610 - 050225......... 95 H................ 050308, ref SDS 38 0001
050611 - 050211......... 78 H................ 050214, ref SDS 37 02BB
050612 - 050128......... 67 H................ 050204, ref SDS 36 087J
050613 - 050104....AC resume 3rd cycle....... 050104, ref SDS 35 407N
050614 - 041228......... 56 H................ 041230, ref SDS 34 087J
050615 - 041204......... 43 H................ 041210, ref SDS 33 087J
050616 - 041104....bevacizumab Taxol ends.... 041104, ref SDS 32 RZ4I
050617 - 041007......... 39.................. 041104, ref SDS 32 087J
050618 - 040923......... 49 H................ 041005, ref SDS 31 087J
050619 - 040908......... 44 H................ 040909, ref SDS 30 087J
050620 - 040825......... 47 H................ 040812, ref SDS 30 087J
050621 - 040811......... 42 H................ 040812, ref SDS 29 087J
050622 - 040728......... 43 H................ 040729, ref SDS 28 2N5J
050623 - 040712......... 47 H................ 040713, ref SDS 27 087J
050624 - 040614......... 55 H................ 040615, ref SDS 26 PX6X
050625 - 040517......... 78 H................ 040601, ref SDS 35 2N5J
050626 - 040420....bevacizumab Taxol begin... 040420, ref SDS 34 9Z5J
050627 - 040311......... 70 H................ 040318, ref SDS 33 SM6M
050628 - 040205......... 60 H................ 040211, ref SDS 32 SM6M
050629 - 031201......... 62 H................ 031205, ref SDS 31 SM6M
050630 - 030912......... 66 H................ 030915, ref SDS 30 SM6M
050631 - 030708......... 68 H................ 030710, ref SDS 29 SM6M
050632 - 030503......... 54 H................ 030508, ref SDS 28 SM6M
050633 - 030403......... 45 H................ 030508, ref SDS 28 SM6M
050634 - 030215......... 46 H................ 030220, ref SDS 27 5E6L
050635 - 030106......... 37 H................ 030109, ref SDS 26 SM6M
050636 - 021204....Taxotere phase II ends.... 021204, ref SDS 15 F5Z5
050637 - 021202......... 41 H?............... 021204, ref SDS 35 SP5G
050638 - 021111......... 36 H?............... 021113, ref SDS 34 Y65I
050639 - 021023......... 33 H?............... 021023, ref SDS 33 SQ5I
050640 - 021002....Taxotere phase II begin... 021002, ref SDS 12 XA5N
050641 - 020930......... 33 H?..29........... 021002, ref SDS 12 SQ5I
050642 - 020917......... 36 H?............... 020924, ref SDS 11 SQ5I
050643 - 020910....Radiation ends............ 020924, ref SDS 11 0J7H
050644 - 020723....Radiation begins.......... 020723, ref SDS 9 0001
050645 - 020717......... 59 H?............... 020726, ref SDS 10 YN5K
050646 - 020629......... 75 H ............... 020705, ref SDS 8 UX6I
050647 - 020610....Taxotere 2 cycles begin... 020610, ref SDS 6 MR5I
050648 - 020608........ 67 H ............... 020614, ref SDS 7 0001
050649 - 020603....AC end after 2 cycles..... 020603, ref SDS 4 WO4O
050650 - 020603........ 108 H ............... 020607, ref SDS 5 X67F
050651 - 020511........ 117 H ............... 020603, ref SDS 4 PJ4J
050652 - 020423....AC adjuvant begin......... 020405, ref SDS 2 6SWS
050653 - 020419......... 81 H ............... 020430, ref SDS 3 7N5H
050654 - 020321......... 85 H ............... 020405, ref SDS 2 6T8K
050655 - 020312....lumpectemy................ 020312, ref SDS 1 Q78M
050656 -
050657 -
050658 -
050659 -
050660 -
050661 -
050662 -
050663 -
050664 -
050665 -
0507 -