My dr does not believe in extending tx

I am waiting for the results of my 12 week VL, probably next Thursday, but at my last appointment I was asking the doctor about extending tx.  He said that he knows that most hep C gurus believe in extending tx, but he does not.  I really didn't get a chance to push the issue, as I feel I have plenty of time, however, if I do go und at 12 or 24 weeks, it appears that everything I have read on this forum seems to indicate that tx should be extended.  Are there specific studies I can quote to the doc or I suppose I could change doctors AGAIN to get what I need.  I have 1a and did get the 2 log drop at week 4.  And why is the SOC to extend tx--there must be some studies to indicate that it is necessary????  
Thanks everyone!
Wilful

[comeagain]

HERES a study that compares three 72 weeks treatments.

http://www.liverfoundation.org/downloads/alf_download_321pdf

ca

[Trinity4]

My hepatologist does not believe in extending 72 weeks either.  I am headed to Atlanta this afternoon.  I have an appointment with Dr. Brian Pearlman tomorrow.  It's a five hour round trip but I'm going to do it because I did not clear at 12 wks.  I cleared somewhere between 15 wks and 24 wks.  I was well prepared with studies in hand and argued admirably with my doctor but he would not hear of it.  He said there is not enough data to support extending treatment will increase my chances of SVR.  BULLSH!T.
So off I go, getting ready to join the 72 wk club - which majorly s-u-c-k-s but has to be done.  BTW, why would you want to extend to 72 wks if you clear at 12 wks?  I would not have entertained that thought had I cleared at 12 wks.  48 wks is sufficient time to treat if you are UND by 12 wks.  Ask for a PCR with a sensitivy <5 IU/ml.  There are other studies that say a person should extend 48 wks out after they go UND.  It really gets way to complicated, and they are only studies, not hard fact.  Some doctors tailor their approach but I don't know if that's the ticket either.  I'm just going to do the 72 wks and hope it works.
In the PEARLMAN STUDY 72 weeks gives a relapse rate for Caucasians of 19% instead of 63% with 48 weeks. Not bad, that is a 70% cut.

So these are the pertinent numbers for us with 72 weeks:

BERG: 32% relapse rate for <6000 IU/ml at pEVR; 40% relapse rate for the entire group of pEVR
        
SANCHEZ-TAPIAS: 26% (or 13%) relapse rate for those non-RVR

PEARLMAN: 20% relapse rate for pEVR

Good Luck and hope you clear at 12 wks.  

[Wilful1]

Well, I always seem to be getting ahead of myself, but I wanted to be prepared in case I don't clear with this last blood test.  I obsess way in advance of everything that might or could happen lol.

[zazza]

http://www.liverfoundation.org/downloads/alf_download_321.pdf

Comeagain asked me to correct his link. He accidentally missed a "dot".

[meki]

Ask Cocksparrow  and Jim...

Cause those two have a lot of info and links.

I dunno what's happened with HectorSF --- miss him completely.

But anyhow - they have the info I think you're looking for ---- PM them if you have to.

Hugs!

Meki

[jmjm530]

Nothing wrong with thinking ahead, in fact a very good idea.

Assuming you're still detectible at week 12,  but have at least a two-log drop, then study data suggests extending to 72 weeks. Other factors to consider include how much liver damage you have and how you're tolerating treatment.

The fact that your doctor doesn't believe in these studies can be a moot point. This discussion group is full of stories where docs offer less than optimal treatment. In most cases these doctors are not liver specialists (hepatologists) but are Gastros. The solution often is to switch doctors to someone more knowlegeable. The plaques on the office wall may look good but the virus really doesn't give a hoot.

-- Jim

[HARRYBEADS]

You are going to clear your week twelve so relax.

Harry

[nygirl7]

As you might know I did treat for 72 weeks.  This way way back when the studies just very very had come out and my doctor knew basically of them but didn't really know anything specific and wasn't into me extending. I was still pos at week 12 but neg at week 24.

I printed out all the information I could.  Then I offered to go get a second opinion with one of the doctors who was lead investigator to the studies. My doc went along with that (I'm lucky I lived in NY). Dr. Jacobson suggested that if I wanted to do everything possible to increase my odds and know at the end of the day I had done all I could that I should extend. He even called my regular GI and explainned it all out to him and then suggested to him to read the Sanchez Tapias study and the Berg Study and figure it out for himself.

If you can't get to a second opinion with one of the biggies who now all believe this way I would go armed with those two studies and back it up with the fact that you know several people who if not for extension believe that they would not have had a snowballs chance in h3ll of making it.  I know I am one of them.

However - hopefully it's a moot point and you are now UND and don't have to worry about it!
'
Just don't give up. After all it is YOUR body and you should indeed have a say in your own treatment. I don't understand these doctors who won't listen to hard fact - they seem stuck in the ice ages and have too much pride to listen to anybody else!

Good luck!