Consultation with Dr. Laheru

We went back to Johns Hopkins to finally meet Dr. Laheru. This is the last oncologist we have on our list to meet. My mother asked him what kind of name "Laheru" is and he replied that it is Indonesian. Dr. Laheru went over my mother's history and then went over his recommended treatment plan. This would be radiation with Xeloda and possibly Tarceva followed by Gemcitabine alone. One thing I felt is that the Hopkins folks stress that my mother's prognosis is very good from surgery alone and that this may have some implications for her treatment plan. Dr. Laheru also mentioned in response to our question that Xeloda was probably equivalent to 5FU but more convenient. He said that if you drew and tested blood after somebody had done 5FU vs. Xeloda, no doctor would be able to detect any difference. He also mentioned that the levels of Xeloda that they would give would also be treating the cancer "systemically" right from the start.

We also talked a lot about the GVAX vaccine. Apparently, they are planning a booster study that they are going to open sometime later this year. He said that my mother would be eligible to receive the vaccine under this study although this would happen after she finishes her chemotherapy. I asked if there were any ways to offer it sooner and he said unfortunately there was no way that would be possible. I really hope that this study gets launched and that the criteria are such that many people can benefit from it.

He mentioned that Hopkins might be able to offer the VMP but it seems like it might be a better idea to do the first part of the protocol at Virginia Mason since they are so experienced with it. We could do the latter part at Johns Hopkins. He wouldn't recommend using Avastin as that is too toxic.

My mother really liked Dr. Laheru and mentioned afterwards a few times that we should use Johns Hopkins. As I mentioned, the last one always seems to be winning. Dr. Laheru stressed that treatment should begin soon (we are at 6.5 weeks post whipple). We now have to make the big decision this weekend.

Dr. Cameron sent us a very thoughtful thank you note for the scarf today.