Belly fluid update

Joe is scheduled this morning for a procedure to insert a drain in his abdomen to relieve the build-up of fluid that has been bothering him for the past week. The drain will remain temporarily until his lymph system has repaired itself.

It appears that this accumulation of fluid is a result of the surgery not due to a malignant process. There may be a minor leak in one of his abdominal lymph vessels. Numerous lymph nodes, including some around the aorta , were removed during surgery on Feb 10th. The no-fat diet that he has been on this weekend is already helping him to feel better. In addition, he is on a neutropenic diet to avoid any possibility of infection. He can have no red meat, fresh fruits or vegetables. The nutritionist will meet with he and Vicki today to outline their recommendations for Joe's meals once he comes home.

Since Joe's immune system is compromised, he will wear a surgical mask whenever in someone's presence. Joe's sister, Michelle from Colorado and brother Bill from Rhode Island came to Rochester this weekend. All three will have blood tests on Monday to determine who has a good antigen and blood-type match to Joe for a possible stem cell transplant. (More about that as we learn more from the doctors.)

Joe will receive another Interferon treatment today and a drug called Sutent. ( SUTENT is a highly selective, multi-targeted tyrosine kinase inhibitor that starves tumors of blood and nutrients needed for growth and simultaneously kills cancer cells that make up tumors. )

Due to the presence of the abdominal fluid, Joe is no longer a candidate for the High Dose Interleukin-2 treatment (Administered over five days in the hospital with VERY SEVERE flu-like symptoms.) . However, the low dose Interferon that he is currently on has exactly the same success rate. He will endure milder form of the side effects for a longer period of time.

"Interferon is given to stimulate the body‚’s own immune system to fight some types of cancer. The exact way in which it works is not fully understood. It is thought to have a wide range of biological effects. It may do one or more of the following:

• slow down or stop cancer cells dividing
• reduce the ability of cancer cells to protect themselves from the immune system
• strengthen the body‚’s immune system."

Joe is ready and very willing to follow his doctors' recommendations to win this battle. Sure, he is going to feel lousy for the short-term, but he is determined to give this fight everything he has.

The words of encouragement from all of his friends are immensely valuable.