Healthy Living by Willow Creek Springs
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What Happens When You Question Standard Cancer Care?
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A raw, unfiltered window into the reality of cancer treatment decisions unfolds in this special subscriber episode of the Healthy Living Podcast. Host Joe Grumbine shares his actual consultation with her medical oncologist, pulling back the curtain on what these critical medical conversations honestly sound like.
The discussion centers around Joe's recent CT scan results, which show partial success – her original tongue mass has disappeared, but lymph nodes in his neck still measure 4cm (down from 6.3cm before treatment). This creates the central tension of the episode: what to do when treatment shows improvement but not complete resolution?
Throughout their conversation, we witness the delicate dance between medical protocol and patient agency. The oncologist recommends the standard approach of radiation with chemotherapy to target the remaining disease. At the same time, Joe thoughtfully questions this path, concerned about long-term quality of life impacts like permanent dry mouth, weight loss, and the possibility of secondary cancers.
What makes this episode extraordinary is Joe's prepared, researched approach to his own care. He inquires about alternative testing methods, immunotherapy options, and reduced-dose radiation protocols. The oncologist responds with candor about the limitations of current medical knowledge, insurance constraints, and the data supporting standard treatments despite their side effects.
This episode serves as a masterclass in patient self-advocacy while respecting medical expertise. We hear how Joe balances his oncologist's recommendations with his research and conversations with cancer survivors who've experienced significant quality of life impairments from standard treatments. The conversation reveals the profound complexity of cancer care decisions where certainty is elusive and personal values must guide choices about risk, treatment intensity, and quality of life.
Whether you're facing cancer yourself, supporting someone who is, or simply want to understand the reality of these life-altering medical decisions, this episode offers rare insight into how patients and doctors navigate these challenging waters together. Have you ever wondered what you would choose if faced with similar decisions? How much would the quality of life factor into your treatment choices?
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Well, hello and welcome to the Healthy Living Podcast. I'm your host, Jill Grumbine, and this is a special edition subscriber episode, and this is basically a listen-in on a call with my medical oncologist, as we're trying to find answers to resolving my cancer. No problem, what's that? You look good. Yeah, I'm fantastic Getting better all the time. You look good. I'm gaining weight back. I'm getting muscle mass back and really going after it. Pain Not at all.
Speaker 1:Okay, and the mouth still feels okay yeah, yeah, I, um, I had a little bit of of issue with um. The last round of chemo hit me pretty hard but I got through it and um, I I used, uh, my ozonated glycerin as a wash and I use um, a buffered saline solution in my mouth and I kept. It got a little raw but it never got to a point where I couldn't eat or anything and it it came back quickly. And then I got a little bit of edema, but not bad, just at my ankles, just a little bit, and no, no, no bone pain or anything like that. Um, a little teeny little bit of achy in my sternum a couple of times, but it was. I think it's the port more than anything. That's a little, you know, you feel it the port, causing the achiness here no, it's just, it's an ear.
Speaker 1:You know, you feel it. It's like it's an ear, you know, you feel it. It's like it's there and I think that, like the part here where it comes up right into my neck, right right there, I can feel it. It's not like painful or anything, but it's, you can feel it, and I think that that accentuated whatever little bit of discomfort I felt. It wasn't pain, it was a little bit of discomfort, but it it was a couple of days over, over the whole period. All right, so I got a lot of questions for you, okay. Well, the first is um, I saw the, the results, the CT scan. I'd like to hear your interpretation of that. And also, I did not get the actual image and I'd like to see if I could get that, just so that I can compare that with the other ones.
Speaker 2:I can't get to the image, unfortunately, especially not on Zoom. I can't do that.
Speaker 1:Oh, no, no, not now, just into my chart, if that's possible.
Speaker 2:No, they don't put the images on my chart, unfortunately. You can definitely get it you can get a cd. Oh okay, oh okay they want to get a cd of your images oh perfect even if you guys are going to come in and you go see somebody else, you just take that cd with you and they can upload it. I have patients who do that for me oh good to do it outside too, so yeah you're the medical records. People will definitely be able to do that for you?
Speaker 1:oh, perfect, I'll do that. And then, um, oh, go ahead, go ahead.
Speaker 2:So I'll start with your neck, because that's where the original disease was. Um, your base of the tongue mass looks like it's gone okay. So that's good. At least radiographically on the CT scan it looks like it's gone. There's nothing there. Your neck node and I know I haven't examined you, but I know Kristen has examined you your neck node was quite large before. They said that it's decreased, but there's still some stuff there. So they measured it, as you saw, at four centimeters and previously they measured it at 6.3 centimeters. That was prior to treatment, so it is still a disease sitting there. Actually, I was a little disappointed with that piece, to be quite honest.
Speaker 1:Do we know that that is cancerous, or do we know that there's just something there still?
Speaker 2:there is no way you're going to be able to know if that was cancerous, or that is, that it is cancerous or not cancerous, without surgically actually taking it out I understand because you can do a biopsy, but you don't know if you are hitting that exact area where there may or may not be disease. So you may end up with an answer that you're either happy about and you shouldn't be happy about, or the other way around.
Speaker 1:I understand. Yeah, yeah, and you're talking about these are lymph nodes. Yeah, okay, this is the same area.
Speaker 2:that was like a big golf ball size before Right To me.
Speaker 1:Visually, looking at you, I feel like that's all gone, yeah, but clearly there's stuff still residual there yeah, I still feel a little bit of something and but remember, you had told me even that the when the tumor is being reabsorbed or going away, that there's possibly some necrotic tissue that would take a while to go away and I'm wondering is it possible that that's what we're dealing with?
Speaker 2:It could be Like I said nobody would know the answer to that.
Speaker 2:When this happens after radiation, like there are people who get radiation and there is still a node left behind there, um, after radiation, and we're pretty much exactly in the same scenario, like we did something and it's changed. But do we know if there's disease there, if there is just scar tissue there? There's no way to know. So it is very tricky to know what to make of that spot. Um, you can do a PET scan to see it as active, if it is active in that area, but that's still not a sure shot.
Speaker 2:I understand you know, the only sure shot is to actually surgically actually say okay, we're just going to take that out and see if there's anything there, and that is probably the only way to know that there's disease there or not there. So that's what I would leave that piece at. There was nothing else in your neck that I saw new, which is sorry. My camera.
Speaker 1:Is it possible, too, that I mean, I still feel the chemo in my body? Is it possible that it's still working and still getting smaller?
Speaker 2:is it possible that it's still working and still getting smaller? Um, let me get your dates and I can answer that in a second. Your last drug dose was june 9th. No, you're out of the range of where I would expect any more response from the okay, because you're more than four weeks out right, right, okay, fair enough so that's kind of where I would stand now. The other bothersome thing that I did not like to see was your lung findings um because on your lung um, and I don't think this is cancer.
Speaker 2:I'm going to start with telling you that because everybody always freaks out when I start talking about something. But they said worsening of mucostasis and bronchiectasis and, like this, ground glass opacity.
Speaker 1:Can I stop you for a second? Because I have a lifetime of lung disease. I've had allergic bronchitis from a young age, asthma growing up and then in the last 20 years I've been dealing with chronic bronchial pulmonary aspergillosis bronchial pulmonary aspergillosis and what happens is when it gets to be a dusty, windy day, it'll aggravate it, and my wife got a flu and she got a lung infection and I didn't get the flu. But I have a sense that we've had a bunch of windy days and I think I picked up some of what she got prior to that, because I had a cough that developed the same way it always does when I get this problem. It's a chronic problem that doesn't have an answer besides steroids and I've I've decided you know I don't do that anymore.
Speaker 2:So the thing is it actually is a worse. That's the part that's a little bit bothersome. I heard that you have a history of allergic bronchopulmonary aspergillosis, correct?
Speaker 1:Yes.
Speaker 2:Have you ever been treated for it before?
Speaker 1:Yeah, I was on steroids for about 10 years and the side effects from the steroids were such that I decided to stop that and I actually came up and I made a formula that I have been taking came up and I made a formula that I have been taking. But it really cleared up and I stopped taking my own formula. So subsequently, when this thing flared up, I started taking it and it's cleared out again. So I would be willing to bet that if I got scanned today, you wouldn't see what they saw there. I mean, I felt it when I was going through the scan. I had a cough, I had the inflammation, I had the fluid in my lungs that I was trying to get out.
Speaker 2:So I will tell you, when you had your scan before your treatment, they still saw it, but it was stable. They said that this is kind of like stable, stable baseline lumps. Obviously, like you said, you don't have normal lungs. That's fine. I've worked with plenty of those people.
Speaker 2:Yeah, the problem is, um, I can bet you money that with the taxol, with the chemo that you got, your immune system drops down yeah so it increases your risk of these lung infections right typically stuff that has been kind of quietly sitting there for a little while, like aspergillosis right so what we're seeing now is that aspergillosis has gotten worse right um I I don't know if you have a pulmonologist. This is absolutely not my area of expertise yeah but if you have somebody that you have been or have gone to in the past, I would go see them. Okay, see if there's anything you need to.
Speaker 2:Fair enough, I'll look up the, the pulmonologist I used to go to and, uh, he at least has my records and everything and we have a history exactly I'll check that out let me just do another ct scan in three months and see if it comes back down to baseline yeah because without chem maybe your body can kind of fight off this infection.
Speaker 1:Yeah.
Speaker 2:Kind of come back to your previous baseline, but I can. My thought was that the chemo allowed this stuff to.
Speaker 1:It makes sense, I agree. I think you're right.
Speaker 2:And then that probably puts you at risk.
Speaker 1:So yeah.
Speaker 2:I was like dang it. We caused problems more than.
Speaker 1:Yeah, but I really feel that even right now, a week and a half later, it's cleared up dramatically from that. So I feel like my immune system is improving. I feel stronger every day. I feel I'm out there working in the farm a lot more and getting stronger.
Speaker 2:Yeah, and honestly, as your immune system gets better, it will probably be able to fight this stuff off.
Speaker 1:Yeah.
Speaker 2:While you were like in treatment, you just didn't have the ammunition, and that's fair, I agree. Okay, so what are we going to do now?
Speaker 1:I know how you feel about the next step, so I'm going to start with how you feel and what your thoughts. Are these two nodes that would be the area of concern right now that it's not cancerous or it's continuing to shrink and go away? We'll know in three months when we get another scan, if that's stayed the same, gotten worse or gotten better, and that'll be a big determining factor in my opinion. I know that you did the NAVDX test and you told me that you believe that that was a very strong indicator. But here's my thought is that shows the presence of the virus, but even though that that was zero the last time or not detected, I still had cancer. So the fact that if it were to show back up, it would be a good indicator that I've got a problem, but there's not, it doesn't tell me that the cancer is gone. There's no way to know that and, like you said, I understand and I've been doing as you can imagine.
Speaker 1:I'm researching all the time, trying to find answers that I can use to build my solution, and I appreciate you being at least patient with me to do this and I think it's been helpful. I've discovered a test that they call the squamous cell carcinoma antigen test. And again, I know it's not a perfect answer, but I believe it could be a good indicator. I don't know if you've heard of it, but there is a test and I think if I can figure out who offers it, I could probably order it myself, but I don't know if that's something that you could order. There's also a test called liquid biopsy. I don't know if you're familiar with that, I don't know how accurate it is, but again it could be another indicator.
Speaker 1:And then there's another test that I've heard of called Signatera. Blood. Test it on my own to look at any number of markers. That might be an indicator. And finally, in Japan they have what they call a METPET, which they don't have it here in the States, but it's a PET scan that, rather than using glucose uses glucose uses methionine as an indicator and it will show directly the cancer uptakes methionine in a dramatic way, more so even than the glucose, where glucose other things can cause it to show besides cancer, even though cancer will generally light up strongly. Other things could be an indicator and I'm trying to figure out how to get there and get this scan done. Um, but again, I have no way to know if I can even do it, or but there is. Those are the four things that I came up with as possible ways to monitor this.
Speaker 2:So Signatera is or Natera. These are all equivalent things that we use. It's very much in line with your NavDX. Okay, it's just different companies.
Speaker 1:Okay, that's the difference, fair enough.
Speaker 2:Okay, so don't chase the Signatera and Natera, because you've already done that.
Speaker 1:Got it.
Speaker 2:It's the same problem that we have. I have personally never heard of this glucomycin antibody. I can't imagine how that helps this scenario. Because you will have antibodies. You will, and I'll tell you why. You have had cancer in your in your recent life. So whenever you have so say I get the flu, you in January. My body will build up the antibodies to the flu virus and hold on to those antibodies.
Speaker 1:Okay.
Speaker 2:For a later day if I get another exposure, what they call a secondary exposure. Right, and that is the concept behind vaccines. With vaccines like the COVID vaccine, the flu shot, all these things that people get, what they give is they give you antibodies.
Speaker 1:Right.
Speaker 2:So that way, your body has these antibodies built in your system to fight it, to fight the infection, if you might call it if that happens. So understand what antibodies are supposed to do.
Speaker 1:Sure.
Speaker 2:Now we know that you have had squamous cell carcinoma.
Speaker 1:Right.
Speaker 2:In the last six months say so. I would expect that your body would have built up antibodies to it, okay it's not going to help me to know now that you have antibodies, because that does not tell me anything about do you have cancer or not. It just tells me that, oh yes, this patient, this person, was exposed to squamous cell carcinoma sometime in his lifetime okay.
Speaker 1:So if, if it were to return, you wouldn't say that that number would spike?
Speaker 2:no, okay because it does not work like that, like you hold on to your antibodies for your lifetime. It takes like people who have chickenpox in there as a baby usually we check their antibodies when they hit like 70 or 80 because it takes like that long for those antibodies to wash out of your system so this said it was an antigen test.
Speaker 1:It didn't say antibody. Is that the same thing?
Speaker 2:and no, the antigen and antibody are two different things yeah, this is an antigen test, not antibodies. It's okay. I heard antibody, which is why I responded with that. Antigen is different, which basically means that you have active cancer, so that is an active exposure. That's the squamous cell carcinoma. I'm still not sure if I personally, in your situation, would feel comfortable relying on that, because that is not proven to be confirmatory, as there is active disease versus not active disease.
Speaker 1:Okay, fair enough, but could you consider that it would? If I didn't rely upon it as the deciding factor, but a piece of information, would you see a problem with doing it? I mean, if I went ahead and found it and ordered it and got it, would you think it would be not a good idea? Or do you think it would be not a good idea, or do you think it would be helpful just to have more information?
Speaker 2:I mean it could be information, but I don't think all information should be used to make medical decisions.
Speaker 1:Right Agreed.
Speaker 2:So if we have still scans that are saying that there's potentially disease there, then I think that's pretty strong evidence that you need additional treatment. I wouldn't. I mean, I know you're looking for reasons to believe that you shouldn't need any more treatment, but I think that's kind of you're fooling yourself by looking for a negative answer when there truthfully may be disease there.
Speaker 1:And please understand, I'm not looking for that, no treatment. I'm trying to look for a treatment that will be the least amount of harm, the most amount of good, and I'm trying to look at all options.
Speaker 2:I know you're hesitant about the radiation piece. You've done the chemo now so you're kind of like, okay, that was manageable, but I still strongly think that the right answer here is to do the chemo and the radiation, think that the right answer here is to do the chemo and the radiation.
Speaker 2:So so, not because that standard of care, but because partly because I see that there is disease still there and your disease burden early on was very high. So your thought about let's wait another three months and get another ct scan and see if something grows you're going to put yourself at risk for whatever is there to kind of either get big too quickly, which would not be the worst of scenarios because we could hopefully just radiate that and take care of it then versus now. But the worry that I have would be that if it lets loose because if it was already in the notes the next place that it's going to go is your lungs.
Speaker 1:I understand and I'm not taking this lightly. Please understand that I'm not just flippantly saying I don't want this by any means. I have two factors involved. One is I have met two people that had what I had and got treated the way you guys have recommended and this was a few years back and both of them said that if they knew today what they knew, or if they knew then what they knew today, they probably wouldn't have done it.
Speaker 1:They would have tried to find another way around, and the reason I say that is because of the damage that was done was such that it's affected their quality of life in a pretty dramatic way, and of course, that brings me a lot of concern, and so here's what I've come up with as well, in looking at standard of care for this head and neck squamous cell carcinoma, I've seen immunotherapy in conjunction with chemotherapy as a treatment that they are looking at. One is checkpoint inhibitors and the other one is CTLA-4 inhibitors, and I don't know if you're aware of that familiar with it. Support it, think it's an idea.
Speaker 2:Those things, but not in this scenario. So the data for that won't be to give it to you, but you need definitive treatment first. So the newest data, which is the NEVO post-op study you can look that up, it's N-I-V-O post-op.
Speaker 2:Or is it post-op NEVO? I forget which word comes first. That's the study that was done and that used the checkpoint inhibitors to reduce your risk of people who are high risk. I-e-u. Okay, so there is data to give these checkpoint inhibitors and CTLA-4 agents, but not as a. We gave the chemo and now you give it for risk recurrence risk.
Speaker 1:What I was looking at was the chemo and this being done in conjunction. So that's what I was looking at. Possibly is a treatment that would involve chemo and this immunotherapy.
Speaker 2:Not that the data that you're reading is for a metastatic disease.
Speaker 1:That's not for people like you Okay, but wouldn't it work better if it was? If it's not metastatic, it's not approved.
Speaker 2:You can't even get an insurance approval for this oh and not, not to mention, we don't have data for it. Logically, you think some of these things would work yeah except they just don't um. The data is absolutely and I give people trust me, this is not new data to me. Chemo immunotherapy combination yeah um, but they're metastatic meaning yes, something let loose and went to another place, and that's what we're dealing with now.
Speaker 1:OK, well, I don't want that clearly, so that's just. Yeah, absolutely fall into the curative category. Yeah.
Speaker 2:And my goal is to keep you there.
Speaker 1:I understand.
Speaker 2:Disregarding that quality of life after chemo radiation is different.
Speaker 1:Right.
Speaker 2:Everybody handles it very differently. So I know you've talked to people who say that they could have should have done something different, and I think hindsight's 20-20. Everybody thinks that they could have done something different.
Speaker 1:Right.
Speaker 2:But also remember these people are alive.
Speaker 1:I understand and I'm weighing all that together. And now some more questions. I have, too, is when you look at the numbers of survival rate. I know they look at five years out, but how far do they look at survival rate? I know they look at five years out, but how far do they look at survival rate?
Speaker 2:So five years out. People do much better when we count those patients, so people who you know, if you make it to five years, you're good Okay.
Speaker 1:So that's kind of the thinking is, if you make it to five years, see and I guess that's where my question is Are they looking at 10 years? Are they looking at secondary cancers caused by the radiation? That's really one of my biggest concerns.
Speaker 2:I would say tell you not to worry about that. If that is your biggest concern, that's the lowest risk that you need to worry about.
Speaker 1:Because the data I've seen says that it's a fairly substantial risk.
Speaker 2:The thing is, you hear, the small percentage of people who have the secondary cancers compared to the general population that we do treat. I would probably say in my entire. In a year I have maybe one or two patients who develop a secondary cancer, probably not even two. I would probably say one a year is what I would put it at I mean.
Speaker 1:I have people that I can count on my hand and I've been in practice for 10 plus years, so keep that in mind, okay so looking back 10 years ago, you would say the same thing that one person a year, that out of that 10 years later developed it okay so that risk?
Speaker 2:yes, I mean we always. You know you're talking about putting somebody at risk for cancer, so obviously we talk about it. There's no argument about that. Sure, okay, but is it like a really high risk versus a small risk? It's a small risk okay it's an incredibly small risk. The other quality of life issues are much higher risk yeah so dry mouth, you know.
Speaker 2:Next, next, swelling, like the lymphedema that they get you know these are. These are true, true weight loss that you're going to have with the radiation. Every one of my patients that you see in clinic, the fellows, can attest to that. I always tell them if you start off at 150 and you lose 50 pounds at 100, you're down to 100 pounds by the time you're done with chemo radiation you are never going to be back up to 150.
Speaker 2:You're going to sit at about 120, 125 at best. Okay, so patients who go through chemo radiation they're never able to. It's not any. You know how people talk about. Oh, I have such a hard time losing weight.
Speaker 1:Oh, I get it, I'm already there. Yeah, I understand.
Speaker 2:Yeah, Is that the worst of scenarios? No, but you know, it is something to, it's a quality of life, thing Right.
Speaker 1:The fact that you will lifelong need to be constantly holding onto a bottle of water to make sure your mouth is not dry when you're talking to your neighbor next door is a quality of life thing, right. Your neighbor next door is a quality of life, right. Right, your connection has gotten poor. Maybe if you turn off the camera it'll get better. I can hardly hear you. No, it's not better, I don't. Yeah, that's better.
Speaker 2:That's interesting.
Speaker 1:Yeah, it affects the bandwidth or something.
Speaker 2:Yeah, so I definitely have people who have the water, that dry mouth issue, the neck swelling issue, and that's more like a very common problem. That's not a one-off kind of thing, but the secondary cancers is more of a one-off kind of thing.
Speaker 1:Okay, what? What are the? What were the drugs that you were going to use for the chemo if I went and got the radiation as well?
Speaker 2:so do you remember when, when you got this round of chemo, you got three drugs? You got the docetaxel, right, the cisplatin and the pump, the 5fu? Yes, it's that same cisplatin, the middle one, okay so your body has actually seen this drug before.
Speaker 2:Okay, so it's just the one drug instead of the three and the reason for that is because it in and of itself, it does not do anything. That's why, when we gave it to you with the, with in this the when we gave it to you before we put it with two other drugs right we made it a combination of cocktail and three drugs got it this by in and of itself, at that dose does not do anything, but it makes the radiation more sensitive, and that's the role for okay so going forward, the radiation is actually doing the bulk of the work.
Speaker 2:We're just trying to make the radiation more effective so if so, the other okay.
Speaker 1:so, aside from these two nodes, if these two nodes went away and I'm not I get where you're at and I understand and I'm equally concerned. We're still showing mass. My concern with the radiation would be radiation is a local treatment, it's not a systemic treatment. So if I've got no mass but circulating tumor cells, what would the radiation do for that?
Speaker 2:So the radiation is not for the circulating tumor cells, you are absolutely correct. So remember that the radiation is not for the circulating tumor cells, you are absolutely correct. So remember that the radiation is targeted treatment. It is actually going to go burn that base of the tongue where the disease started from, as well as those nodes that showed disease in the first place, because that is where the disease landed. So if you take, burn that down and I do use the word burn- I get it.
Speaker 2:It's appropriate yeah then that burn actually will char it down so that area does not have an ability to grow back. Now you brought up the concept of circulating tumor cells. The radiation does not do anything about the circulating tumor cells because it is not a systemic therapy. You are absolutely correct, which is why we do give that cisplatin, because the thought is, even at a low dose, hopefully some of that can tackle any of those circulating tumor cells. But in your case my gut is that your circulating tumor cells were hopefully taken care of with the induction chemo that we gave you Okay, and I would hope that as well.
Speaker 1:And I know I have a meeting next week to speak with the radiation oncologist and we're going to discuss this as well and I don't know, in some of the, again, I'm trying to find a way to do the least harm and the most good. They were talking. Some of the studies I've looked at were showing that, like what his approach is going to be is a pretty heavy dose for a pretty prolonged period of time. It was like five days a week for five weeks or something like that. It was a pretty dramatic.
Speaker 2:Typically six weeks yeah.
Speaker 1:Yeah, so that's going to be a lot of radiation in a long period of time and it'll be difficult for me to even do that to come down there every day for that amount of time. It'll be very difficult for me to manage that. But I was also looking at studies that showed a smaller dose of radiation can also be very effective in a situation like mine.
Speaker 2:I mean, I know he's the guy that does the radiation, but just want to hear your thoughts on that so that's a valid question and that question has been asked again and again, and again and again, believe it or not, not by you, but like other people sure um I once again. The radiation oncologists do the radiation, so definitely ask them that question of course right the wheelhouse and they know the data on this.
Speaker 2:But there are things called de-escalation where they have given people chemo two cycles not even three up front, followed by lower dose of radiation and that the um. So instead of getting 60 gray, I think they gave 50 gray. It's still not as small as you would like it to be yeah so you know you were saying five days a week for six weeks yeah I think they go five days a week for five weeks.
Speaker 2:That's what the de-escalation was okay um, but the data has not proven to be beneficial okay that's why. But I will tell you, that question has been asked again and again, so it keeps coming up, because we're looking for minimizing the toxicity from the radiation. So the verdict is still out on that.
Speaker 2:And people still are erring on the side of doing the 60 because all the studies up until this point have suggested that we really shouldn't be dropping the dose. Yes, it may save you from the toxicity from the radiation, but your disease is going to come back. So that's kind of what we're battling. But I know even UCI has a study. Unfortunately you would not qualify for that.
Speaker 2:Disease is going to come back so that's kind of what we're what we're battling right, but I know even uci has a study. Unfortunately you would not qualify for that. We actually not too long ago I ran a study for this about two years ago. It closed because once again we didn't find benefit and then they reopened it okay in the same vein to see can we reduce the dose. So the study is open. But you would not qualify because you already got the chemo.
Speaker 2:You have to be on the study when you get the chemo, okay, but you can always ask the radiation oncologist. Can you guys treat me like that trial at a lower dose and see how they feel about?
Speaker 1:it Okay and I think we're getting close to all the questions I have. The issue that I have still is I've still got to get dental clearance. Now that the chemo is done and you say it's done performing, I can begin that again. I know that while it was going through I was recommended not to deal with any dental work, so now I've got to go back and try to get that restarted. The last time I was doing it I was trying to rush it and get it done right away so that this thing wasn't going to kill me, which fortunately we came up with an answer. But I'm still back to where they have several teeth that they want to deal with and I've got to go and try to mitigate that. You know, the first dentist said I got to pull all your teeth out and I'm like, okay, so I'm back to this craziness and so I got to go back and get reevaluated and begin that process. Hopefully it won't be a long process, but I still have to deal with it.
Speaker 2:So so you go see the radiation doctors next week yeah um. Circle back with me what your thoughts. Okay, see what you want to do okay I think the radiation doctors will reach out to me as well. If you guys come to some kind of discussion decision about what to do okay. All right, well, I you're just kind of on cruise control mode right now. Just recovery time for now.
Speaker 1:And then there's still the issue with the port having to be. There's, yeah.
Speaker 2:Yeah, I think you have two appointments.
Speaker 1:I do. That's what those were for. I wanted to clarify. I saw that those two appointments it didn't really 24th when you come to see Dr Ho, so you don't have to double your visits oh, we were going to do a video chat, but I, if I'm going to be there for that, I can just meet him in person.
Speaker 2:That'll work yeah, I'll ask um. Would you rather come on, because I don't want to move dr ho's no, no I'll have jasmine move your your flesh appointment to the 24th.
Speaker 1:That's a good idea yeah, if we can do that, then then I can just kill two birds with one stone and meet him in person. I think that's good.
Speaker 2:We'll be in the same building. You'll be downstairs for home, upstairs to flush.
Speaker 1:Perfect, all right. Well, that's great. I am so grateful you took the time to go through all these things and I'm looking forward to solving this thing once and for all.
Speaker 2:That sounds like a great plan. Let me know what you need from me, okay.
Speaker 1:I sure will Thank you so much.
Speaker 2:Bye-bye.
Speaker 1:All right. So, as you've heard, you know she didn't change her thought and I've still got to try to find my way through this. So, as you know, I'm working on this NORI protocol, which is a natural cancer or chemotherapy program, and they don't want to hear about that. I didn't even want to bring it up. So I got the answers I needed as far as what she wants to do and we'll go from there. All right, this has been another edition of the Healthy Living Podcast subscription episode and I thank you for all your support and tell somebody about it if you think it was worth it.
