There have been lots of changes since the last Sparky Report.
The sub-lumbar tumors have gone through some changes, but the overall gain is not as much as hoped. The inguinal tumor has gotten larger and firmer as well as developing a more nodular shape and a thicker "strap" reaching into her abdomen. Additionally, the perianal tumor has increased dramatically both in mass and distribution around the rectum. As a result the output has become more restricted causing Sparky to have to strain and to eliminate small masses (as little as 1 cc) much more frequently.
The conclusion is that the Carboplatin is not effective on these tumors and a new course of radiation is needed specifically for the perianal masses.
Instead of the Carbo', Sparky is now on Melphalan (Alkeran) which is taken orally. (Sparky's mom gets to practice safe removal of contaminated gloves like she learned in ERT every time Sparky gets a dose. OK, so it's a good news/bad news thang.) Now, in addition to watching for neutropenia (from the therapies) and hypercalcemia (from the tumors), we should also keep an eye out for thrombocytopenia (low platelets) and anemia from the Alkeran.
The new course of radiation will be another seven treatments, but the field will in the perianal area and will be complex. That is, to avoid nuking her rectum and colon (which is what we're trying to keep functioning) while getting as much tumor coverage as possible, the field is broken into multiple regions. The change of fields means that they can't use the originally shaved areas for triangulation, so she has a newly shaved area: her butt. She has now had three of the seven treatments.
Sparky's appetite has mostly been good until this Sunday. The "road kill" (Hill's Prescription Diet n/d) that she once devoured three times a day no longer excites her. However, if we add a little seasoning or flavorful sauce, she'll still eat well. That changed on Sunday. The best she would do is to eat a couple of nibbles of frankfurter. Unfortunately, she yakked that up a couple of hours later and yakked again later in the afternoon. She also developed a raging case of diarrhea the likes of which her mom has never seen. That evening Sparky got Metronidazole instead of Clavamox against possible protozoa, though one of the possible side effects of Metronidazole is anorexia.
Still, Sparky's mostly happy and playful not knowing how sick she is. Her mom and grandma are glad they can spend so much time with her these days.
Stephanie Fenton
A.K.A. Sparky's Mom