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So Dad was released Friday evening from Barnes. They sent him home with an increased dosage of steroids to take until his appointment with Dr Ansstas (medical oncology) on Wednesday.

After talking with Ansstas prior to being discharged, we got some clarification on a couple of things. They are taking Dad off chemo completely right now, they want to get the swelling down in his brain and chemo does not work fast enough. They seem to be more concerned with the swelling than the actual tumor growth at this point. They are recommending he take Bevacizumab (the same drug associated with the clinical trial, is also considered the "standard of care") whether he participates in the trial or not. This drug attempts to slow down new blood vessel formation and slow down the blood supply to the tumor. They will also keep him on steroids until his appointment and then eventually taper the dosage down once he starts the Bevacizumab (also called Avastin, much easier to pronounce and type). There is a risk with Avastin, approximately 1 out of every 10 people have a stroke, heart attack, or blood clots from being on the drug since it's goal is to cut off blood supply. While this is a low number, it's still something that we have to consider. This drug will not cause any nausea or confusion, which this would pretty much be the only drug he's on that doesn't.

As far as the clinical trial goes, he would receive the VB-111 every two months through an IV and then remain at the clinic for 8 hours afterwards for observation and monitoring. The group that only receives the Avastin is only monitored for a short time after receiving the medication so we will know which group Dad is placed in. He would receive Avastin every two weeks through an IV.  This trial is currently in Phase 3 and appears safe for most patients. We should see an improvement after 1 or 2 treatments and this treatment should hold the disease for approximately 16 weeks, meaning there shouldn't be any tumor growth for that period of time. I read that Temodar (the chemotherapy he was on) can usually hold the disease for approximately 6 months so hopefully the information on Avastin is accurate as well.

Visiting Barnes...

Well, we are back in the hospital again...

Late Wednesday night Dad had a very hard time getting comfortable and couldn't fall asleep. Finally he told Mom that he also had a headache and she took him to Barnes in St Peters. They did another CT Scan which showed swelling in the brain and was putting pressure on his brain and causing his headache. His doctors wanted him down at Big Barnes so he was again transported by ambulance downtown. He was given an increased dosage of steroids as well as a medication similar to Excedrin to help with the headache. Since then he has been feeling better and his headache has been gone for the most part.

Yesterday I wasn't able to be up at the hospital but Mom and Dad were able to talk to a few of the doctors.. We got the results from his MRI he had on Tuesday (this was a scheduled MRI and had nothing to do with his hospital visit) and it showed growth on the tumor. Because of the growth, the doctor running the clinical trial decided to pull him from the current trial with the Disulfrum. His doctors have also decided to try a different form of chemotherapy since the current plan is clearly not working.

We're still waiting to hear from the doctors on what they want to do as far as chemotherapy, but it sounds like they may try one through an IV or through a port. We do know he qualifies for a different clinical trial that is targeted towards a recurrent glioblastoma. I haven't been able to speak to the clinical coordinator yet but it involves two different medications that are given through an IV. One of those drugs is VB-111 that "is designed to try to kill cancer cells in the body by attempting to "cut off" the blood flow to cancer cells and/or tumors. If VB-111 is successful in cutting off the blood supply to the tumor, the tumor may not be able to grow." In this trial, like most trials, there is an experimental group and a control group. The experimental group will get the VB-111 and a second drug called Bevacizumab, while the control group only gets the Bevacizumab. From the little bit I've been able to google search, Bevacizumab is used as treatment for several types of cancer including glioblastoma multiforme and can slow the growth of new blood vessels. According Wikipedia, it can slow tumor growth but does not affect overall survival rate.

We did hear from the doctors via phone and they said Dad will be discharged today, however we are still waiting for them to come by and see him. Thanks for all the thoughts and prayers, I will update once we know a little bit more!!!