Treating Pulmonary Embolism - anticoagulants with brain tumour

My husband has been admitted to hospital with suspected Pulmonary Embolism.
The doctors are reluctant to prescribe anticoagulant due to risk of brain haemorrhage.
I am looking for any advice from anyone who may have had similar experience.

I just want to let everyone know that my daughter Debra is doing very well after the Pulmonary Embolism. She is home from the hospital and back to about the same activities. She will be one blood thinners for at least 6 months. I did research several clinical trials and it does appear quite common to accept patients whom had DVP or PE on trials as long medical management is working.
I am surprised that none of her doctors have ever mentioned the higher risk for blood clots (7 times) for all cancer patients and that this is even higher for Pancreatic and Brain cancer patients.
I recommend that everyone educate themselves as to the symptoms of a blood clot. Thank God that Debra recognized something was seriously wrong and went to the ER at 3 a.m.!

My daughter was diagnosed with GBM last December. She has finished radiation in April and is continuing the oral chemotherapy. She has done quite well physically but her last MRI was showing some 'enhancement' causing some concern. Yesterday she had a Pulmonary Embolism, so she is in the hospital being monitored and given blood thinners. There is a concern since her platelets are already borderline low. I read last night online that blood clots is 7 times more likely in cancer patients and that Pancreatic and Brain cancer patients seem to have an even greater occurrence of PE. I was surprised that her doctors had not warned her of this possibility and the symptoms to watch for. We are just lucky she decided early in the morning that something wasn't right and immediately went to the hospital. I hate to think about what could have happened if she had waited longer.
Also, she is taking a typical drug cocktail. I am wondering if there are anyone out there following this blog who have had a similar experience and if there are certain supplements that should be avoided now that she has had this clot.
Also, her records have been reviewed by UCSF for a possible clinical trial. She doesn't  qualify at this time. I am wondering if have a Pulmonary Embolism would disqualify her for clinical trials. Any advice, answers??

Linda W.

Switching Tamox for Letrozole

Hi All!

Since my wife is in process of recovering from her last surgery (3rd) on OCT-19 , she is doing rehab sessions for the secuels (hemiparesia left side), so her ability to move is limitated for now. So we are thinking switch High Dose of Tamoxifen (160mg daily) for Letrozole. The thing here is I'm not able to find any paper with and estimated/recommended dosage for glioma.

If anybody can enlighten us, any comments will be appreciated.
Thanks!!!

Aspirin (or Celebrex) synergize with anti-PD-1 therapy in melanoma mouse model

Cyclooxygenase-Dependent Tumor Growth through Evasion of Immunity

(This study is also open access and can be dowloaded as a free PDF from the link above)

In this study, immunocompetent mice bearing melanoma syngrafts were treated with either aspirin (in the drinking water), or an anti-PD-1 antibody (similar to nivolumab or pembrolizumab), or both drugs combined.  Aspirin alone had no significant effect on tumor growth, the PD-1 antibody had a modestly significant effect, while the combination of both agents was highly effective, with over 50% of mice rejecting the tumors.  When a larger number of melanoma cells was injected into a new set of mice, neither drug alone had any effect on tumor growth, while the combination of both aspirin and PD-1 antibody led to tumor regression at day 30.

Similar experiments were repeated with celecoxib/Celebrex (injected intraperitoneally), with similar results, though slightly less effective than aspirin in the melanoma model.

A similar experiment was then carried out using aspirin and the PD-1 antibody, but this time using colorectal cancer cells.  Again, aspirin alone was ineffective, the PD-1 antibody was modestly effective, while the combination was highly effective, with about 30% of the animals rejecting the tumors.

when to start tamoxifen

Dear stephen and everyone,
We are now 1 week post radiation..and we r supposed to start ccnu after another 2 weeks..
i am planning to combine ccnu with tamoxifen..and i read that Ben started tamoxifen 2 weeks prior the chemo..

So I am thinking this means we should start tamoxifen now gradually..
what do u think?? Is it safe to start it now with a small dose??

Sarah

Ben Williams - cocktail profile

Ben Williams' treatment summary as it appears on astrocytomaoptions.com.

Ben's tumor was recently determined to be positive for the IDH1 mutation, and positive for MGMT promoter methylation.


  

Information compiled from Ben’s book Surviving Terminal Cancer, and from the summary of his story at virtualtrials.com.


• March 31, 1995. At the age of 50, Ben underwent a subtotal resection of a large (180 cubic centimetre) glioma of the right parietal cortex, and was given an initial diagnosis of anaplastic astrocytoma, which was later upgraded to glioblastoma after a more thorough inspection of the resected tumour tissue. Extensive residual tumour remained post-surgery.
• Radiation therapy consisted of the standard 55-60 Gy to the tumour area plus 2 cm beyond the tumour boundary.
• The first MRI post-radiation showed neither shrinkage nor growth of the tumour.
• June 1995. Two weeks prior to his first round of chemotherapy Ben began taking oral high-dose tamoxifen at a dose of 220mg daily. Tamoxifen treatment was continued until March 1998. Side effects of tamoxifen included blood clots which he treated with Aspirin and long walks.
• July 1995. First round of intravenous BCNU (carmustine) chemotherapy combined with 600mg per day of verapamil taken during the week surrounding BCNU chemo. The verapamil was intended to block the drug extrusion pump mechanism at the blood-brain barrier, and therefore increase the penetration of BCNU past this barrier.
• The first post-chemotherapy MRI showed a moderate degree of tumour shrinkage.
• Between the first and second round of chemotherapy, Ben began taking oral Accutane (13-cis retinoic acid) at a dose of 160 mg per day on a two week on/ one week off schedule (he later reduced the dose to 120 mg per day). Accutane was not taken on the days of chemotherapy. Accutane treatment continued until December 1995.
• Also around this time he added melatonin at 15mg per evening and the immune-boosting mushroom supplement polysaccharide Krestin (PSK) at a dose of 3 grams per day. He continues taking 10mg of melatonin to this day (2014).
• August 1995. Second chemotherapy cycle, this time consisting of oral procarbazine, oral lomustine (CCNU) and intravenous vincristine. This regimen is known as PCV. Verapamil was again taken to improve the brain uptake of the chemotherapy during the week surrounding oral lomustine treatment.
• Second post-chemotherapy MRI showed an “enormous” reduction in the residual tumour.
• Third chemotherapy cycle, PCV.
• Added oral gamma linolenic acid (GLA) at a dose of 2-2.5 gram GLA daily, consisting of 10 capsules of borage seed oil.
• Late November. Third post-chemotherapy MRI again showed substantial shrinkage of the residual tumour.
• Early December. Fourth cycle of chemotherapy consisting of BCNU. Ben decided to switch back to BCNU due to stomach pain caused by procarbazine and neuropathy caused by vincristine.
• January 1996. Fourth post-chemotherapy MRI. No evidence of residual tumour, first “clean” MRI.
• Fifth cycle of chemotherapy again consisted of BCNU, followed by another clean MRI.
• The sixth and last cycle of chemotherapy consisted of PCV with a half-dose of vincristine to increase its tolerability. This was again followed by another clean MRI.
• Many clean MRIs followed, though Ben continued daily high-dose tamoxifen treatment until March 1998.

Blood Clots are Common with Brain Tumors

When Chance was recently diagnosed with a blood clot in his upper left leg, he was told to go off all meds and supplements until he could meet with the hematologist. He did so and at the hematology appointment, the doctor told us blood clots are common in brain tumor patients.

We wondered why we hadn't been warned.

In Natural Strategies for Cancer Patients by Russell L. Blaylock, M.D., page 33 states: "Maintaining adequate magnesium levels is especially important in preventing surgical and postsurgical complications. Magnesium is one of those nutrients that seem to have an unlimited list of benefits. In addition to playing a role in more than 300 enzymes, it regulates blood flow, protects brain cells, protects the heart muscle, reduces the risk of cardiac arrhythmia, improves lung function, improves kidney function, and prevents one of the most frightening complications of major surgery: blood clots.

I have used magnesium in my neurosurgical patients for more than fifteen years and have never had a patient develop postoperative blood clots in the legs or lungs."

Of course, magnesium is a blood thinner too, so how much to take could be problematic...

Stephen, any thoughts?