Questions on Clinical Trials

Dear Doctor:
I am Stage 3c Poorly differentiated Papillary Serous , Platinum Refractory.
Have received 7 treatments of Doxil.
My Ca 125 has ranged from 1249 to 731 up and down.
I had a ct scan January 5, which said no change, stable.  It did show a minimal nodule in the right pelvic area. Doctor said this was in the area that was related to the feet, and my feet were inflammed at that time.  Doctor said that it could be cancer, but since is was only 1 centimeter that he would keep a check by scans and exams. Doctor wants me to try a clinical trial.  He says if I do one more regular drug, I will not qualify for any more clinical trials.  Doctor suggested one in Tucson, Arizona that is Avastin/Tarceva.  I would have to fly from Texas every two weeks.  I also don't know at this point whether insurance will cover additional expenses beside the drug because they may not be in their network. The other study is at MD Anderson, Topetecan/Iressa. I am a little worried about the side effects of Avastin that can be fatal in some cases.  
I am very worried about what to do and kind of at a loss.  I am also worried that the nodule they mentioned in the cat scan could be cancer.  I asked the doctor about this Tuesday and he said that if it was we would be doing the same thing we are doing now, chemo.  I guess that makes sense. I feel well, and on the whole very healthy, but I just don't want to Put off what needs to be done.  Also it looks like I may be at the end of my drug choices.  Is this true, or do I still have more options.  


plady

[Annekathryn Goodman, M.D.]

Dear Plady,

First of all, you are not harming yourself by waiting a few weeks. The only situation where time is of the essence is in surgical emergencies such as certain types of bowel obstructions. it is important to carefully weigh the various choices. i would think that if Houston is closer, it is safer to receive your therapy from a place that you can get to fairly quickly ( I know Texas is a big place!)

Let's see what other clinical trials MD Anderson has that you could consider
please keep me posted

best wishes

[plady]

To clarify:  The Ca 125 marks that I mentioned are during the Doxil treatments.  My ca125 went down with carbo/taxol to 5, but came back up after 3 months.

Thanks,
plady

[plady]

Just received a post saying that Avastin was not treatment for microscopic cells.  My ct scans have all been clear except the last one showe the 1cm nodule.  My pet scan in Jan 06 showed microscopic cells.  So would Avastin not be a wise choice for me?

thank you
plady

[plady]

Just drove to Houston this morning, only to find out that the clinical trial for Topetecan/Iressa has been closed.  They suggested that I go through evaluation there to see what studies I will qualify for.  I am leaning this way, as I feel like this will be a good place to get into and more trials may be availble for me through them.  Have to decide whether to do this or try Arizona.

plady

[plady]

I apologize for asking so many questions, but my mind is realing at this point.  I guess my main worry is all the time it is taking to go through the processes to get something done.  Am I harming myself by nor doing something more quickly as far as my treatments are concerned.  My last treatment of will be 4 weeks ago this Thursday.

Thanks,

plady