Monday, January 29, 2007

2/29/2007 New date for Cycle 4

New date for Cycle 4 of Interlukin-2 is set for next Tuesday 2/6/2007.

Jimm y B.

1/29/07 Cycle 4 postponed!!!!!!!!!!!!! (IL-2)

Cycle 4 postpone due to nasal infection/head cold. I am going on antibiotics today. I hope to reschedule for next week. I will keep you informed.

Jimmy B.

Thursday, January 25, 2007

1/25/07 Round 4 with the Devil!!!!!!

Well, I got the word that round 4 will start next Tuesday January 30th . Dee and I will drive downMonday and stay at the Shady House if they have an opening. I am not looking forward to this cycle of interlukin. I am still trying to recover from the last cycle. Fatigue has really hit me hard. I feel like I aged ten years.

Well enough complaining. I just hope that the therapy is continuing to shrink the tumors. Then it will be well worth the pain and agony.

Take care, and I will try to stay in touch while I am in the hospital.

Jimmy B.

Monday, January 22, 2007

1/22/07 I am still here!!!!!!!!!

The headaches finally subsided!!!!!!!!! I‘ve been resting. Fatigue has set in. It is the worst bout of it to date. I sleep 8 to 9 hours but wake up very tired. It is like I have never slept. It doesn’t help that I have to go to the bathroom every two hours too. My skin is flaking and is causing me to itch all over. My skin feels like a reptile with scales. I have tried Lubriderm but it only last for a couple of hours. Tonight I am going to try an oil bath. This should be fun.
I am not complaining, things could be worse. Like going back down to Pittsburgh for another cycle. I am now waiting to hear when this is going to happen.

That is it on my end.
Take care
Jimmy B.

Monday, January 8, 2007

01/06/2007 So I am Going Home …. Yah Hoooooooooooooooooooooo!

So Saturday morning I got myself packed and ready to go home from Shadyside. I had called Dee the night before and to get ready for a road trip. I knew I would get release sometime Saturday. The Doctors usually make their rounds in the morning and then write their scripts and then sign release forms. I guess I have the system down. So Dee left Rochester around 8:30 am and would arrive around 1:00 pm. Well the timing worked out just right that I got released at 2:00 pm and we were on the road by 2:30 pm. We arrived back in Rochester a little bit passed 7:00 pm. Round three is now over and I must gain my strength back.

01/05/2007 Eight Is Enough !!!!!!

8 Doses were enough for me. I started experiencing great swelling and sharp pain in my chest every once in a while. So threw up the white flag and gave in. I said to myself “Stop now and there will always be another day to fight this terrible demon.” It was Friday and I would need to recover at least 24 hours before I would get my release papers.

1/09/2007 Off to donate some blood.

I hope they can find a good entry point to draw some blood. When they put in the PICC line, they made a mess if my arm. With my arm bruised and battered, it looks like I am doing drugs. My soars in my mouth are going away and my appetite is coming back. My body weight is just about the same weight as before I was admitted. The 24/7 headache has been a challenge. Tylenol is taking the edge off of it.
Well I am off
Take care,
Jimmy B

Friday, January 5, 2007

01/05/2007 I started my 8th dose of interlukin-2

I started my 8th dose of interlukin-2 and all is going well. I feel I may be able to handle on one or two more doses. I didn’t have the swelling to bad. I think I will be going home Saturday or Sunday. Time will tell.
Take care
Jimmy B.

Thursday, January 4, 2007

01/04/2007 I start my 6th dose at 3:30 pm.

It is a go to get my 6th dose. So far they seem easier to handle. It looks like my belly has bloated up. My legs so far are in good condition. They are using blood pressure medication to keep my pressure in check.

I guess, no news is good news.
Take care,
and I will write after the next dose.
Jimmy B.

Wednesday, January 3, 2007

1/3/2007 Working on my Fourth Dose!!!!! (Interlukin-2)

The third dose went pretty well. I just had the chills so I was given Demerol. The next dose (4th) is slated for 11:30 pm. To keep me entertained, I am watching the ND vs LSU ( I believe it is the Sugar Bowl.)
That is It for now
Jimmy B.

1/2/2007 The first dose

I received my first dose at 3:30 pm and it went off without a hitch. About an hour and a half into my treatment I got the chills so I received some Demerol. Sometime during the 8 hours cycle my blood pressure began to elevate. This is not good. They need to maintain it or I would have to skip the next dose. Well the pressure did not stabilized so I was off the hook for the next dose. I missed the 11:30 pm dose. During the off hours they gave me some blood pressure medicine to get my pressure under control. By 5:00 am everything was back to normal and I am slated to receive my second dose of interlukin-2 at 7:00 am.
That is it for now.
Jimmy B.

01/2/2007 A funny thing happen along the way to getting a PICC Line!!!!!!

Everything was going so smooth until I was to have the PICC line put in. Shadyside is a teaching hospital so I was going to have a resident put the line in under the supervision of the doctor on duty. Usually the Physician Assistant, Dave would be doing the procedure but they lost the PA supervisor to another job opening. The PA supervisor gave 6 months notice, but the hospital administrator staff never replaced him and the PA cannot practice without working under a PA supervisor (an MD).

To make a long story short, the resident had major trouble finding a vein to work with so the doctor took over. Since the doctor didn’t do this PICC line procedure very often, it was like the blind leading the blind. The 20 minutes procedure turned into an hour and half. The doctor used two PICC lines. The first one got damaged while trying to find a working vein. All the while Dee was in the waiting room. I had told her that the procedure took about 20 minutes. She was climbing the walls. I think she was able to finish knitting the baby scarf in that amount of time.

It was now 1:30 pm and we headed up to my room (718) main.

Tuesday, January 2, 2007

1/2/2007 The Next morning. I am in BIG Trouble

I had set my alarm for 6:45 am, I thought but I forgot to set back the time on the clock (Fall Back) so I woke up at 5:45 am. Boy, did I hear it from Dee. She could not sleep to well because I had the windows a cracked to let in some fresh air and plus the room was quite warm. The city traffic never stopped and the bus stop on Centre Ave was right below our window. You could hear the Bus’s air brakes each time they stopped. It reminded me of the old steam locomotives with all the hissing sound. I was waiting to hear the conductor to say, “All aboard”. You also could heard the bus take off. I got use to it, but Dee was a different story. She said she woke up every 10 to 15 minutes all night.

Anyway, we got ourselves together and headed over to Ritter’s Diner for some breakfast. We had our usual, eggs and home fries with a side of bacon, and a coffee to wash it down. After breakfast we went back to the Family House and checked out and were at the Hillman Center by 8:30 am. We were ahead of schedule. I checked in and had my blood work done. We then went to terminal D where I had a once over from Jan the physician assistant. I asked for an official copy of my CT scan for my files. I always like to see things in writing.
My next appointment was at Shadyside Hospital to have my PICC Line put in. This was my ultimate test to see if I knew the right procedure for admission to Shadyside. The last two times things got all screwed up.

So, we are off to Shadyside using the internal bridge to get there. I hope there are no trolls along the way.

Jimmy B.

1/2/2007 We’re Here!!!!!!!!!!!!

Well we made it in record time. It took about 4 hours and 15 minutes to get down to Pittsburgh. The roads were pretty empty on New Years Day. I was driving like a bat out of hell. I don’t know why. We were in no rush. I guess I wanted to catch some bowl games on ESPN. We left around 11:00 am and got there about 3:15 pm. Mary Coyne greeted us at the Family House. Dee And I proceeded to check in to room # 406. It is in the front of the house facing Shadyside Hospital. We could see the helipad on top of the hospital.

To kill some time before dinner, we decided to take a walk to the local market. This helped to stretch our legs after the long drive. We did some sight seeing in the store. We didn’t need any groceries because we brought our dinner from home. On the menu was pepper steak over a bed of white rice. Too much to our surprise, when we returned the Shadyside Family House, they had a great spread in the kitchen. It was leftovers from the New Years Eve party. So, we had H'Orderves and sparkling juices for our appetizers from 4 to 6 pm. Dinner followed.

After dinner we returned to our room and I watched the bowl games and Dee knitted or read a book.

We crashed about 10:30 pm.

Monday, January 1, 2007

1/01/2007 Happy New Year!!!!!!!!!!!!!!!!!

Well, we are on our way back down to Pittsburgh (Interlukin-2). We decided to travel a day early because they want me at 9:00 am. So we are trying to get a room at the Family House across the street from Shadyside Hospital. I will be there for 5 to 6 days. I am not looking forward to this visit.

Anyway, I will try to stay in touch while I’m down there.

Take Care

Jimmy B.

Greetings to One and All

This Blog is dedicated My Brother Kenny B. who passed away in the late 1970's with Cancer before the Internet.

It was he, who showed me How to live and give back. He was wise beyond his years.



Kenny B




Jimmy and Dee

Carepage: Jimmybreitfeller
Jimmy Breitfeller


My Profile as of 2009

My photo
Last July (2005)I was riding my bicycle to work at the Eastman Kodak Research Labs about 3 miles from home. I was wearing a knapsack to carry my things to and from the labs. I started noticing an ache on my back. So I decide to go to the dermatologist. To make the long story short, it was cancer. I knew from my research that I would be needing adjuvant therapy. So I started communicating with Sloan Kettering, University of Pittsburgh Cancer Center, and a couple of others including the Wilmot Cancer Center at Strong. I realized that by telling my story, I might help someone else out there in a similar situation. So to all who are linked by diagnosis or by relation to someone with melanoma, I wish you well. Stay positive, read as much as you can (information helps to eliminate the fear associated with the unknown), and live for today, as no one can predict what tomorrow may bring. Jimmy B. posted 12/15/08

Disclaimer

The information contained within this Blog is not meant to replace the examination or advice of your Oncologist or Medical Team. The educational material that is covered here or Linked to, does not cover every detail of each disorder discussed.

Only your physician/Oncologist can make medical decisions and treatment plans that are appropriate for you. But, An Educated Consumer is a Smart consumer.

As Dr. Casey Culberson Said:

"The BEST melanoma patient is an ACTIVE PARTICIPANT in his or her treatment
(not a PASSIVE RECIPIENT)"

Melanoma and the “Magic Bullet” (Monoclonal Antibodies)

Just to let you know I posted the first draft of the Melanoma and the “Magic Bullet” (Monoclonal Antibodies). on Melanoma Missionary In the Shared File Section. you can download it for 19.95 (Only kidding) it is Free for the taking.


It is 33 pages long and may help you in your quest for the Yellow Brick Broad. Just to let you know it is only the first draft. Revisions are sure to come. I wanted to get it to the people that need it the most, the Melanoma Patients.

Preview:

So, where does Interluekin-2 (IL-2) come into play? According to Byung-Scok et al and recent reports, IL-2 is not needed for developmental CD4+ CD25+ Treg cells in the thymus but does play an important role in the maintenance and function in the peripheral.18 Peripheral is defines as secondary system outside the bone marrow and thymus. It entails the site of antigen, immune system interaction. IL-2 is required for the peripheral generation of Tregs based Abbas’s and colleagues research.19

IL-2 prevents the spontaneous apoptosis of the CD4+ CD25+ Treg cells. It has been reported that patients with multiple advance-stage tumors have elevated levels of Tregs within the tumor microenviroment.20 Interluekin-2 is the survival factor for CD4+ CD25+ Treg cells.21 If the addition of IL-2 is on or before the maximum propagation of the CD4+ T cells, the Tregs population can increase 5-fold in a 96 hour period based on certain growth mediums.

By controlling the addition of the endogenous IL-2, one has a knob to turn and can lead to the control of the expansion of the Tregs. When you combined this control with the anti-CTLA-4 blockage, you can shift the balance of the immune response.

Now here is the catch. The maintenance and function of the CD8+ T-cells require CD4+ cells which secrete IL-2. So we don’t want to deplete the CD4+ cells, we want to control the expansion of the Tregs which are a subset of the CD4+ cells. It has been postulated by some researchers that the Anti-CTLA-4 blockage also suppresses the Treg function in a different mechanism. By using IL-2 as the rate limiting factor, we can suppress the CD4+ CD25+ Treg cell expansion by controlling the concentration and timing of the Inerluekin-2 at the tumor microenvironment.


The Interluekin-2 plays another role in this Melanoma Maze. In a study by Janas et al, Il-2 increases the expressions of the perforin and granzyme A, B and C genes in the CD8+ T-cells. This increase expression causes the CD8+ T-cells to mature into Cytoxic T Lymphocytes (CTLs). The exogenous IL-2 is required for the granzyme proteins. As stated previously, CTLs have cytoplasmic granules that contain the proteins perforin and granzymes. A dozen or more perforin molecules insert themselves into the plasma membrane of target cells forming a pore that enables granzymes to enter the cell. Once in the tumor cell, these enzymes are able to breakup (lyse) the cell and destroy it. This is the beginning of the end for the cancer cells. The tumors begin to shrink and the rest is history,



On the other hand, prolong therapy with Il-2 can result in causing apoptotic death of the tumor- specific CD8+ T-cells.23

Clearly in a clinical setting, timing, dose, and exposure to these drugs play a major roll in the immunotherapy, and can have dramatic effects on the outcome.

All it takes is that one magic bullet to start the immune reaction..

https://app.box.com/shared/kjgr6dkztj

Melanoma And The Magic Bullet (Monoclonal Antibodies)

Public Service Announcement

A call for Melanoma Patients by Dr. Steven A Rosenberg

"We continue to see a high rate of clinical responses in our cell transfer immunotherapy treatments for patients with metastatic melanoma", Dr. Rosenberg said.

"We are actively seeking patients for these trials and any note of that on a patient-directed web site would be appreciated."

If you would like to apply for his trials, here is the website and information.

Dr. Rosenberg's information


Dr. Rosenberg's Clinical Trials


For the Warriors




The Melanoma Research Alliance has partnered with Bruce Springsteen, the E Street Band, and the Federici family to alleviate suffering and death from melanoma. Please view Bruce Springsteen’s public service announcement inspired by Danny Federici. Danny was the E Street Band’s organist and keyboard player. He died on April 17, 2008 at Memorial Sloan-Kettering Cancer Center in New York City after a three year battle with melanoma.


http://www.melanomaresearchalliance.org/news/PSA/

Source Fastcures blog



Join the Relay for Life!!!

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Dear Family and Friends,

I’ve decided to take a stand and fight back against cancer by participating in the American Cancer Society Relay For Life® event right here in my community! Please support me in this important cause by making a secure, tax-deductible donation online using the link below.

To donate on line now, click here to visit my personal page.
Jimmy B AKA Melanoma_Missionary

Relay For Life® is a life-changing event that brings together more than 3.5 million people worldwide to:

CELEBRATE the lives of those who have battled cancer. The strength of survivors inspires others to continue to fight.

REMEMBER loved ones lost to the disease. At Relay, people who have walked alongside people battling cancer can grieve and find healing.

FIGHT BACK. We Relay because we have been touched by cancer and desperately want to put an end to the disease.

Whatever you can give will help - it all adds up! I greatly appreciate your support and will keep you posted on my progress.

Keep the Fire Burning!!!

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Sincerely,

Jimmy Breitfeller
Turn off Music before you "Click to Play"
Signs of Melanoma Carcinoma Skin Cancer

How Skin Cancer Develops by "About.com : Dermatology"

Call for Patients with Unresectable Liver Metastases Due to Melanoma



Delcath Systems Granted Orphan-Drug Designations for Cutaneous and Ocular Melanoma


Delcath is actively enrolling patients in a Phase III clinical trial testing its proprietary drug delivery system, known as Percutaneous Hepatic Perfusion (“PHP”), with melphalan for the treatment of ocular and cutaneous melanoma metastatic to the liver.

This NCI-led trial is enrolling patients at leading cancer centers throughout the United States. Commenting on these orphan-drug designations, Richard L. Taney, President and CEO of Delcath, stated, “These favorable designations are important steps in our efforts to secure Delcath’s commercial position upon conclusion of our pivotal Phase III trial for metastatic melanoma. We remain steadfast in our commitment to become the leader in the regional treatment of liver cancers and we continue to enroll patients in this study, and advance our technology and the promise that it offers to patients with these deadly forms of melanoma and other cancers of the liver, all with limited treatment options.”

Orphan drug designation, when granted by the FDA’s Office of Orphan Products Development, allows for up to seven years of market exclusivity upon FDA approval, as well as clinical study incentives, study design assistance, waivers of certain FDA user fees, and potential tax credits.


Current Trial Centers


Phase I Study of Hepatic Arterial Melphalan Infusion and Hepatic Venous Hemofiltration Using
Percutaneously Placed Catheters in Patients With Unresectable Hepatic Malignancies



James F. Pingpank, Jr., MD, FACS
Associate Professor of Surgery
Division of Surgical Oncology
Suite 406, UPMC Cancer Pavillion
5150 Centre Avenue
Pittsburgh, PA 15232
412-692-2852 (Office)
412-692-2520 (Fax)
PingpankJF@UPMC.edu


Blog Archive

Call For Melanoma Patients!!!!

Call For Melanoma Patients!!!!

Dr. Rosenberg Has a New Clinical Trial.

Our latest treatment has a 72% objective response rate with 36% complete responses.

We are currently recruiting patients for our latest trial.

Is there some way to post this “Call for Patients” on the web site?

Steve Rosenberg

Dr. Rosenberg's Clinical Trials



(For a copy of the research paper.. see My Shared files)

The news headlines shown above for Melanoma / Skin Cancer are provided courtesy of Medical News Today.