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| 25 new of 480 responses total. |
rcurl
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response 150 of 480:
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Oct 21 16:57 UTC 2003 |
If all that is a CT scan, what is a CAT scan? (I had what was described
above, with an IV contrast agent, for a renal examination. I think I
had a CAT with a californium injection for a bilary inspection. The
latter was detecting the radiation from the californium and the former
was using x-rays from an external source. Is that the substance of the
differences, or is there more?)
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goose
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response 151 of 480:
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Oct 21 17:15 UTC 2003 |
RE#145 -- It kind of tasted like warm yogurt, mixed with chalk. Even thinking
about it now induces a nausia...I really would have appreciated it if it were
cold, but I drink cold things all the time.
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keesan
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response 152 of 480:
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Oct 21 19:47 UTC 2003 |
I think CT and CAT are the same thing - computed tomography and computer
assisted tomography. The former name is preferred now, at least that is what
they call it at U of M hospital. Maybe goose had the unflavored stuff. My
first time in July my urine smelled like the stuff I drank for 10 days
afterwards but this time I don't notice any smell in it.
I had a MUGS exam in which they took some of my blood and added something
radioactive to it and injected it back. I don't know the details as I was
half asleep at the time. It was done by Nuclear Medicine dept.
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keesan
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response 153 of 480:
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Oct 21 19:50 UTC 2003 |
CAT - computed axial tomography. I could not find MUGS so perhaps I got the
term wrong (unless you want a mug from a company called nuclear). MUGA?
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keesan
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response 154 of 480:
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Oct 21 19:59 UTC 2003 |
The MUGA scan
The MUGA scan (MUltiple Gated Acquisition scan) is an extremely useful
noninvasive tool for assessing the function of the heart. The MUGA
scan produces a moving image of the beating heart, and from this image
several important features can be determined about the health of the
cardiac ventricles (the heart's major pumping chambers).
How is the MUGA scan performed?
A MUGA scan is performed by attaching a radioactive substance,
Technetium 99, to red blood cells, then injecting the red blood cells
into the patient's bloodstream. The patient is then placed under a
special camera (a gamma camera), which is able to detect the low-level
radiation being given off by the Technetium-labelled red cells. (The
level of radiation to which a patient is exposed during a MUGA scan is
felt by experts to be minimal - it is in the same general range as the
level of radiation received with a chest x-ray.) Since the red blood
cells (including those that are radio-labelled) fill the cardiac
chambers, the image produced by the gamma camera is essentially an
outline of those chambers. With some fancy computer manipulation, the
the final product is a movie of the heart beating.
What can be learned from the MUGA scan?
Several important features of cardiac function can be measured from
the MUGA scan. If a patient has had a heart attack, or any other
disease that affects the heart muscle, the MUGA scan can localize the
portion of the heart muscle that has sustained damage, and can assess
the degree of damage. But more importantly, the MUGA scan gives an
accurate and reproducible means of measuring and monitoring the
ejection fraction of the cardiac ventricles.
The left ventricular ejection fraction (LVEF) is an excellent, and the
most commonly used, measure of overall cardiac function. The ejection
fraction is simply the proportion of blood that is expelled from the
ventricle with each heart beat. So, for instance, if the left
ventricle ejects 60% of its blood volume with each beat, the LVEF is
0.6. (A normal LVEF is 0.5 or greater.)
[Here is why they did this scan on me. Adriamycin is what is causing my
laryngitis. They only did the MUGA once while I was in the hospital,
after the first chemotherapy. I was wondering about the purpose of it.
Nice to know my heart is okay, even though my pulse still goes way up when
I bend over.]
A common clinical situation in which repeated MUGA scans are useful is
in following a patient's cardiac function during the delivery of
chemotherapy for cancer. Some chemotherapeutic agents (adriamycin
being the most notable) can be quite toxic to the heart muscle. By
measuring the MUGA ejection fraction periodically during chemotherapy,
oncologists can determine, on an ongoing basis, whether it is safe to
continue with the therapy, or whether certain medications need to be
stopped. The MUGA scan is accurate and reproducible enough to detect
subtle, early changes in cardiac function that might easily be missed
by other techniques. It is a highly effective, noninvasive means of
monitoring one of the worst side effects of chemotherapy, and allowing
that therapy to be delivered more safely and effectively than would
otherwise be possible.
~ [76]Richard N. Fogoros
63. http://results.about.com/health
I am starting to find out what other tests were done in the hospital as the
bills come in. I think they checked my lymphoma cells to make sure they were
displaying the correct antigen before treating with Rituxan.
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klg
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response 155 of 480:
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Oct 22 01:50 UTC 2003 |
Are u gettin a PET?
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keesan
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response 156 of 480:
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Oct 22 13:48 UTC 2003 |
klg: No PET that I know of. Did you get one and if so why?
My good news for this week:
Date: Wed, 22 Oct 2003 09:07:07 -0400
To: keesan@cyberspace.org
Subject: Re: CT scan
Your CAT scan shows a very nice response.
Enlarged lymph nodes previously seen in the chest have resolved. In
the abdomen the lymph nodes have also pretty much resolved and the
spleen has returned to near normal size.
Looks good!
Judy
>>> Sindi Keesan <keesan@cyberspace.org> 10/21/03 12:04PM >>>
Please can you let me know the results when you get them today or
tomorrow. The scan was Monday evening.
Sindi Keesan
--------
Sounds like I still have some abnormal lymphocytes (tumor cells) but less
of them in fewer places. Hopefully the next three treatments will shrink
everything back to normal size. I wonder why the Rituxan does not get all
the cells on first exposure. The other drugs only get cells while they
are dividing, which they must not do every day.
Yesterday's walk was around the neighborhood. It was too close to rush
hour to cross the main streets but today we might try to get across
Liberty for a walk. Just a block down Jim's street he nearly stepped on a
large garter snake on the sidewalk adjacent to the yard where they do a
burn every year and plant prairie vegetation.
The hand where they put the IV last treatment has finally stopped hurting
again. It started to hurt again about the 10th day of the cycle, maybe
from scars forming? I asked the CT nurse to spare my hand as I needed it
for infusion. Anyone know why the infusion people insist on using hands?
(It is more convenient as I can keep my shirt rolled down to stay warmer.)
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keesan
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response 157 of 480:
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Oct 22 15:35 UTC 2003 |
Now that I have been pronounced okay (moving in the right direction) Jim
accepted a couple of translations for me this morning. I still have the
problem of pain in the sit bones if I try to work for long, but my brain seems
to have recovered at least. The shaky hands are less shaky while typing but
I still make more mistakes. The first job is something interesting about a
gadget to help heal broken bones, which I hope I never need to use. It is
not clear from the drawing or the text whether something is a plate or a strap
- maybe Jim can figure it out from the other drawing. Got to get to my
apartment somehow for a better dictionary.
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tod
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response 158 of 480:
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Oct 22 15:41 UTC 2003 |
This response has been erased.
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jiffer
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response 159 of 480:
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Oct 22 22:43 UTC 2003 |
A lot of cells go through a "lag" period before starting the "log" period
(division), so you may not always catch cells via their method of
reproduction. You are also dealing with "immortal" cells (which cancer cells
are). I should research how Rituxan is supposed to attack these cells. It
is difficult to attack eukarotic cells that are attacking the body because
you are made up of eukarotic cells, bacteria (prokarotic cells) are much
easier to deal with.
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keesan
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response 160 of 480:
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Oct 22 23:59 UTC 2003 |
Re 158 - Russian.
Re 159 - the body is set up to attack abnormal body cells because they put
out a sort of distress signal in the form of a protein on the surface which
Rituxan helps the body to recognize by binding to it. Some cancer cells
probably stop making this signal - I hope I don't have any of those.
Anyone know how often cancer cells reproduce and how long the drugs are in
effect?
Today's exercise was a car ride downtown and some walks around the bank and
farmer's market. We ran into friends twice, one of whom had gone to Croatia
for tests when she got sick because one test here costs more than a bunch of
tests there and airfare both ways. One farmer told me about her sister who
died of cancer in her nose, but only after 18 years of treatments. We then
visited a friend who isolated me in a room behind a glass door. His resident
child and her two friends kept coming by to wave at me. They know all about
white blood cells because they studied AIDS in elementary school.
I had better get back to translating before the next one arrives. There is
a sideways view of the thing that is either a strap or a cover plate and it
could still be either one.
The funny taste that I notice when I eat fruit was also there when I tasted
a tootsie roll at the bank (Jim ate it for me) so maybe it is the sugar in
the fruit that is tasting sort of sour. Odd. Water also tastes funny.
We have two buckets of grapes to clean and juice after this translation. Lots
to accomplish before Monday when I am out for a week again. Another apple
tree to pick Saturday when they have scheduled warmer weather again. Are
there any stores near Briarwood that sell cheap writeable CDs? A friend will
trade us a working CD writer (probably antique) for a package of them.
It is such a pleasure not having to take any pills or gargles for a whole
week. Or move over 12" every time I roll over on the new 3' wide mattress
pad. We stopped for a receipt for the first one (I must have lost mine) and
got a tour of the future Sleep Shop next to the birkenstock store - bare walls
and a just-sanded floor that will unfortunately need to be covered. Grand
opening Dec. 5 (just before my last session).
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keesan
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response 161 of 480:
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Oct 23 13:39 UTC 2003 |
Today I can taste the cider and my finger has stopped bleeding next to the
nail. I have 5 fingers and a thumb with shredded skin or healed bleeding,
one of which was bleeding just last night. And the big news is I slept 8
hours only waking once in the middle (which probably means I am not forcing
enough fluids but it is nice to sleep more than 2 hours at a time).
My doctor friend sent me a copy of the actual CT scan report, which says that
ALL my lymph nodes are back to normal size. The formerly huge masses in the
spleen are greatly shrunken. The fluid is gone from around my right lung but
it is still there around my left lung and is consolidating (which is not
good). I also still have sore ribs due to pleural effusion on the left side.
My friend listened to my lungs by tapping on them while I breathed in, and
you could hear the difference in pitch between them.
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klg
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response 162 of 480:
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Oct 23 16:06 UTC 2003 |
I was so whacked out by the chemo I used to sleep 12 hrs at a stretch.
(Still woke up tired, tho)
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keesan
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response 163 of 480:
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Oct 23 16:37 UTC 2003 |
During what part of the cycle? The first week the prednisone keeps me from
sleeping more than 3 hours at night. Were you as bony as I am?
I am still getting hot every once in a while, which I don't think I found as
a side effect of any of the drugs. Perhaps this is hot flashes due to my
period stopping in July when I lost weight down to 103. It is distinct from
the night sweats I had in July which were caused by the tumor, where I was
sweating all night without even any blankets or top sheets, in just a t-shirt,
at 78 degrees. Those stopped with therapy. But I have to take off blankets
or clothing once in a while for a couple of minutes to cool off, then I get
cold and put it all back. It is still 65 degrees in Jim's house and I am
wearing a thin wool sweater, wool vest, and fuzzy bathrobe, with cotton long
underwear and thin wool socks and wool cap. I wore a wool sweater at 73
degrees. Still no body fat - I wonder where the 12 pounds went.
Back to looking up the structure of a thigh bone for my translation. Boy am
I glad I don't need to fix any broken bones.
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klg
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response 164 of 480:
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Oct 23 16:44 UTC 2003 |
all during the cycle, from about December - March
thin, but not bony
never had any of the classic lymphoma symptoms
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keesan
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response 165 of 480:
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Oct 23 16:48 UTC 2003 |
Did you find that you were sleeping more after the last few therapy sessions?
I slept a lot during the day during the first session (2-3 naps) and have
needed to nap during the first two weeks of this session, but don't sleep more
than 8 hours at night.
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klg
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response 166 of 480:
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Oct 23 16:53 UTC 2003 |
no
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keesan
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response 167 of 480:
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Oct 23 19:12 UTC 2003 |
Today we walked across Liberty and then back, and around some new areas. We
found a rose tree with large fruits which Jim sampled, and nearby a large
paper wasp nest high in a tree. Still no frost.
Jim says he is getting out of shape as I get into shape because he is not
biking many places, or working on the house. These short slow walks with me
are not exercise for him. He wants to go dig up the yard (burdocks). First
he is looking over my translation to help figure out if things are slots or
notches (I apparently have both), explaining the use of a cam, and pointing
out that the drawing of the gadget is missing a few lines and could not
possibly work as drawn. I finally sent the insurance company receipts for
the mattress toppers (but forgot to include a copy of the prescription).
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keesan
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response 168 of 480:
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Oct 23 21:18 UTC 2003 |
Jim helped me turn a socket fork wrench into a spanner wrench and then went
to bed complaining he felt sick. I feel fine and am about to start a second
translation, also medical. Finally sent off two receipts and a prescription
for mattress toppers.
We discovered that if someone sends something on the superfine setting to a
fax machine without this setting it reverts to standard setting. You learn
something every day. So we plugged in another 'broken' machine from the same
friend that does superfine. He did not want it back after Jim got it going.
I am back on vacation starting Monday. If anyone wants to visit do it before
then.
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keesan
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response 169 of 480:
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Oct 24 02:40 UTC 2003 |
Jim's brother the radiologist tells me that lymph cells divide as often as
once a week and that it would take 20 weeks for one abnormal cell to grow to
a 1 cm tumor. In July I had a mass (tumor) in the spleen 8 x 13 cm which is
now down to 4 x 5 cm, implying that the tumors started at least 6 months
before that CT scan was done, back in the winter or before that. He says good
CT scan results are necessary if a cure will be possible. What is a cure?
5 cm is 2 inches. When this was larger I did not feel like I had much space
in my stomach. The spleen lies on top of the stomach (from the front view).
Jim and I have been trying to make sense of a translation where they kept
changing what was 'down' or 'under' depending on the viewpoint.
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tod
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response 170 of 480:
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Oct 24 20:12 UTC 2003 |
This response has been erased.
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keesan
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response 171 of 480:
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Oct 24 21:56 UTC 2003 |
I was wondering if a cure was lack of tumor cells or lack of symptoms.
Today Jim wore a pedometer when we walked to the Chinese buffet west of
Stadium Blvd. 3/4 mile there, 1.9 miles total including walking around in
the restaurant and to the library. I could probably make it the mile to Main
St. but might have trouble coming back, plus there is nothing much to do on
Main St. and the library and market are still further away. Next cycle?
There are irregular quarter-sized black spots with white borders on many of
the Norway maple leaves again this year. Some fungus? Jim sampled the red
sumac flowers and says they taste lemony. We said hello to a neighbor on his
street whose husband died of liver cancer 12 years ago tomorrow.
Jim sorted half the grapes (removed stalks, moldy ones, and beetles).
I may try turning the handle of the squeezo juicer for arm exercise. I was
able to crack my own fresh pistachio nuts (in the husk) using both hands.
I have been doing occasional vertical pushups against the wall or door,
and leg lifts. I tire quickly (and get bored too). But I no longer get
exhausted just trying to sit up in a chair. It gets easier.
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keesan
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response 172 of 480:
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Oct 25 01:13 UTC 2003 |
I just did some more online research. Rituximab targets not just cancerous
B-lymphoma cells but regular ones as well, if they have CD20 marker, which
over 90% of lymph cells have. I think they tested my abnormal cells to make
sure they had CD20. So this explains why my blood lymphocyte count (which
is small and medium lymphocytes, while the tumor cells and other lymph cells
in my lymph system are large-cell lymphocytes) is continuing to be slightly
low. It will take 9-12 months after therapy for my lymphocytes to recover,
meaning I am more susceptible to infections until then.
There are two types of lymphoma - indolent or slow growing or follicular is
the first, and often they don't treat that until the symptoms become a
problem, and what I have is called aggressive or diffuse which grows faster
and can be fatal in six months if untreated. (I would have either starved
to death or stopped breathing due to fluid around the lungs.) But the latter
is potentially curable and chances are up to 90% if I make it for two years
without any 'events' (recurrence of symptoms?). My chances of making it
event-free for two years are higher with the Rituxan (57%). Two year survival
is 70% on average but higher for me since I had a good CT scan. It sounds
like 'cure' means all the tumor cells are killed. These statistics are for
people over 60 and my chances are higher since I am somewhat younger.
If there is a recurrence of symptoms then they treat you again, often with
different chemicals than before, and your chances of being around five years
afterwards are not so good. My mother made it about 3 years after the first
treatment and 2 or less after the second, with just radiation for brain
cancer (which I think cannot be treated with chemotherapy due to the
blood-brain barrier but I am not sure.)
I guess I will know more after 3 more treatments.
I fell asleep in the early evening again yesterday and today. I wonder what
causes the fatigue. My hemoglobin is back to normal, that can't be it.
Tumors cause loss of 'lean body mass' (muscle). I am back up to 107 or 108,
same as in April when I had plenty of muscle, but I still don't have much
muscle. I cannot figure out where the weight is going. Maybe internal
muscles? Internal fat?
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keesan
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response 173 of 480:
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Oct 25 01:57 UTC 2003 |
I checked my blood counts and my lymphocyte count is within normal range at
the end of each cycle: absolute count is 1.1 and normal is 0.8-5.0. So I
am low normal already and therefore will not need 6-9 months to return to
normal. The other counts are also low normal but monocytes (neutrophil
precursors) and neutrophils (fight off infections) were normal-normal.
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keesan
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response 174 of 480:
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Oct 25 15:15 UTC 2003 |
I forgot there are two types of lymphocyte and I probably have plenty of
T-cells and not many B-cells. The counts do not distinguish.
I just got an encouraging e-mail from the author of some DOS software that
I use, who went through two years of hormone therapy for prostate cancer and
said he had male menopause - hot flashes, emotional instability, etc. I am
still getting hot flashes (having to take off a layer for a few minutes every
hour or so). What other symptoms are expected from menopause? I don't think
I have any of them so maybe the hot flashes are related to the drugs? I did
not have them before chemotherapy and I think it has been only a few weeks.
Apparently each type of cancer is treated differently.
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