Liver toxicity update and DR. DRUKER

[Guest guest]

Hi all--

¡¦s liver counts have recovered significantly from being OFF Gleevec for

7 days now, his blood/platelet counts are all in the normal range..on the

low side of normal, but normal nonetheless! His liver is still ¡§out of

whack¡¨, so they are keeping him off Gleevec another 7 days to see if his

liver recovers more. At that point, his onc. (along with her contacts at

Novartis), will put him back on Gleevec¡Xonly at 300mg, and monitor him

closely.

We have made the necessary phone calls to Dr. Druker¡¦s office and are

waiting for calls back. We have contacted our health insurance (Kaiser

Permanente), and have found out that in order to be covered at all, ¡¦s

oncologist must refer us direclty to Dr. Druker. In talking to ¡¦s onc.,

she has said at this point she will not do that. See, Kaiser is closely

affiliated with The City of Hope Cancer Research Center, and Kaiser refers

patients to the CML specialists at The City of Hope first (in fact, many of

those doctors are actually Kaiser doctors). In fact, when was

hospitalized last October due to severe neutropenia, we actually did get

referred to The City of Hope and got to see their lead CML specialist. He

was very knowledgable and after going through ¡¦s records, told us at

that he really believed that due to ¡¦s Gleevec break, his counts would

recover on their own, explaining that many new patients on Gleevec suffer

from Neutropneia because Gleevec is targeting the ¡§leukemic¡¨ cells, and

since most of his cells were ¡§leukemic¡¨, that of course he was suffering

from neutropenia. He told us that we had to give it time, and ¡¦s counts

would come up, and that once back on Gleevec, he would probably do quite

well. And that is precisely what happened.

But, during that time this same CML specialist also had ¡¦s name put on

the Bone Marrow Transplant list ( is an only child, sibling match is

impossible), and discussed the option of a BMT. Which makes sense, since

this doctor (CML specialist) is also head of the Bone Marrow Transplant

program. He also mentioned many times that he knows Gleevec very well since

he was part of the initial trial program, but we were still leary just in

that he is head of the Bone Marrow Transplant program, and understandably

might try and push that option. But, even he said BMT is a last resort, and

front line treatment is Gleevec¡Kthat made us feel a little better!!

With all of this said, we still want to see Dr. Druker, because¡Kwell..it¡¦s

DOCTOR DRUKER!! So, now we are at a dilemma. See, we are willing to pay the

costs ourselves, and go to Dr. Druker. But what if he wants to put on a

different regimen than ¡¦s onc¡Khow could we follow that advice without

being covered by our insurance? That potentially could get very expensive.

We very much respect and trust ¡¦s onc., and so far she has proven

herself to be extremely knowledgeable in CML, and Gleevec. She is constantly

consulting Novartis, as well as her contacts at City of Hope, too. We see

her side, too, of not wanting to refer a patient to another specialist,

since she already has her own specialists she can refer patients to. We were

honest and told her all of this, and she said that by all means, she would

respect Dr. Druker¡¦s opinions and medical advice.

So-for those of you who¡¦ve seen Dr. Druker¡Xhow do you manage that

relationship along with that of your local oncologist? Does Dr. Druker

become your ¡§primary¡¨ doctor? Or, do you just consult with him and get his

take on things and then you, yourself, have to relay that info to your own

oncologist?

Sorry for the long post ( would be so upset telling me to ¡§cut the crap

and get to the point¡¨!!!!)¡Kwhat can I say, it¡¦s the age-old topic of

women saying 30,000 words per day while men say something like 5,000. ļ

Cervera

_________________________________________________________________

PC Magazine’s 2007 editors’ choice for best Web mail—award-winning Windows

Live Hotmail.

http://imagine-windowslive.com/hotmail/?locale=en-us & ocid=TXT_TAGHM_migration_HM\

_mini_pcmag_0507