Saturday, November 1, 2014

So What's This New Treatment?

It's time I provided a bit more information to you about Steve's new tumor treatment with the Novocure TTF. The TTF stands for Tumor Treating Fields and it has electrodes, taped on Steve's head in which the currents alternate directions. It "uses electric fields within the human body that disrupt the rapid cell division exhibited by cancer cells.  These results demonstrate both disruption of cancer cell division up to complete cessation of the process, as well as complete destruction of the dividing cancer cells."  
There is a video on their website that shows how cell replication is interrupted by the alternating tumor treating fields:  http://www.novocure.com/ttf_therapy.php?ID=16  It uses some technical jargon but only lasts a minute and a half, and the picture shows how the cells have trouble replicating. Since cancer cells replicate much faster than normal cells, they are more sensitive to the TTF than normal cells, and therefore able to die off more quickly.

On Thursday, 10/25/14, they had a Novocure representative at their house who spent about 3 hours training them in their new equipment. Dr. Hu made a map of where to place the electrode arrays on Steve's head. We understand the location often changes after MRIs based on changes in the tumor.


Electode array
There are 3 electrodes arrayed together under one piece of tape and 4 arrays taped to his head.  His head is shaved with an electric razor every few days. They have extra tape to use when the edges start to come off. There is only about a half inch of skin showing between each array. There is a wire coming off each array long enough to reach his hip. These are braided together and plugged in to the main device. It's the size of laptop with a front panel display, power button, error alarm and lo battery light. It records an Excel-type spread sheet of Steve's actual use and what error alarms occur at what times. The Novocure representative comes out weekly to download the information and provide supplies.


The whole shebang
The back pack provided has side vents and a hole on the side for the wires to go through. It doesn't fit over both shoulders so he uses one long strap over one shoulder instead. There are 2 main devices. One uses rechargeable batteries and has a base unit for the 4 large batteries. Each battery only lasts about 3 hours. He has 2 complete sets of charging units: one for home and one he keeps at work. He also has a second device he uses at  home which plugs in to the wall. He uses it near his favorite chair in the family room and then he has to carry it upstairs for bed every night. It is a bit cumbersome to haul his  stuff every time he wants to get up from his chair. I understand it's kind of heavy, too.

Steve said he initially felt a warm tingling sensation when the unit was first put on, but now he does not feel anything. The doctor wants Steve to wear the device on average 20 hours per day, or 80% of the day. Steve's first week averaged 85%.  There is always some time when the unit is off every day:  showers, head re-shaving, when the electrodes are not making good contact or are being replaced every 3-4 days.

Our sister, Lesley told me Steve's personal goal is to wear the machine 95% of the time. She said he has an excellent outlook on the whole thing since he said "this machine is keeping me alive so I'm just going to live with it". And then he picks up all the cumbersome equipment and carries it around with him, even a million times to answer the door for trick or treaters, or to get on the treadmill. They have learned to braid the wires on the right side of his head so they don't tangle when the bag is on the passenger seat of the car. Steve wears a baseball cap most of the time to cover the arrays.

So far, Steve has not had any side effects. The typical side effect is irritation of the skin under the electrodes. He has a cortisone cream for when that happens. It would be applied for 10 minutes, then wiped off with alcohol so the arrays would re-stick to his head. He's not even had any pain when the tape is pulled off or when being shaved down to bare skin :)

Compared to chemotherapy the side effects are nearly inconsequential. With Temodar, he had nausea, needing meds, constipation, needing meds, serious kidney problems and then he had to stop taking it in August because his blood platelets got too low. With Avastin, he had a life-threatening blood clot with leg pain, now needing twice a day shots in his stomach and he gets diarrhea and feels cold very easily.
There are lots of other side effects which could be serious, too and we worry about "chemo brain" over time. Lesley said Steve's stomach looks horrible from all the bruising from the blood thinner shots. He looks like got beat up and lost. Terry does that to him, LOL.

So that's the current news on the Novocure device. I'm looking forward to seeing a picture of Steve with it on and will pass it on to you when I do.