As of Tuesday, I am no longer
participating in the clinical trial. Given that the last CT showed
no evidence of effectiveness, and after the supraventricular
tachycardia and the pericardial effusion, my oncologist decided that
the risk of serious side effects was too great. I was ready for
three more weeks, but he wouldn't agree to it. Of course, I am
disappointed, but I have to admit that I am relieved and feel
somewhat better—more energy. Do I feel better because the end of
the trial created a placebo effect, or do I really feel better? Who
knows? We'll have to see what happens. The plan is to do nothing
for sixty days, and then have a CT to assess my status at that time
and see what the next move should be.
The next day I had a very good
appointment with my cardiologist. I'm also in a wait-and-see
position with my heart. I'll have periodic echocardiograms to see if
the pericardial effusion (fluid build up in the sack around the
heart) comes back. If it does, I'll see a cardiovascular surgeon to
determine whether I need a pericardial window. That is an operation
in which they cut a hole in the pericardium to let the effusion drain
into the chest cavity. It is not a minor surgery, so if I need it,
the question is whether I am up to the surgery.
Yesterday I got a pathology report on
the fluid drained from the pericardium. Combined with the previous
reports we know that the fluid contained no aerobic or anaerobic
bacteria, no malignant cells, but did contain a few mesothelial
cells. The leading hypothesis is that the effusion was caused by
mesothelioma in my pericardium. The pleural effusion that I was
having at this time seven years ago was caused by my then-undiagnosed
mesothelioma, so it doesn't seem like much of a stretch to believe
that the recent effusion is also caused by mesothelioma, but this
time in my pericardium.
David
