Palliative care vs Hospice care -- 11/3/2025

Last week,we met with the fellow, Dr. Tim Caradonna, leading my oncology team and decided at each new setback we need to  discuss Quality of Life issues and decide if the treatment plan is worth it (Palliative care) or if we should stop treatment and focus on Quality of Life issues only (Hospice care).  

The challenge is I keep having brain mets that prevent me from using immunotherapy until the swelling goes down.  Our current plan is to do the Cyber Knife X-ray treatment to kill the current  brain mets and then use Avastin to reduce inflammation while tapering down on steroids so I can use the  Keytruda to kill any new mets. Avastin can be used with steroids (dexamethasone) and with Keytruda. The issue is whether the Avastin with a steroid taper will allow me to reduce the brain inflammation enough to maintain enough mobility to make the outpatient appointments

We're currently going to try following the plan.  For me that means eating well every day and trying to get mobile.

On Halloween 2025, I had an appetite and ate all of my breakfast.  I also had a good PT session and walked for 20 minutes with a walker and a cane, and walked up and down stairs.  So I can get from the curb to my wheelchair and this will let me take get a ride  to get to appointments.  One day at a time!

Yesterday, on November 2nd, I was discharged to my home, and its great to be home.
I had a nice sleep last night, and a delicious breakfast followed by PT exercises. Now I’ll take a nap from 9-11. This afternoon we will take an outing where I go down the stairs to the car, then we drive to look at leaves, then return home and I walk back up the stairs… We’ll do an outing every day to practice getting to the car and back! If problems with mobility arise I'll contact my oncology team, and temporarily increase the steroids.  

I'm optimistic about this plan as it will lead to systemic therapy with Avastin, to keep tumors from growing and reduce bran inflammation, and Keytruda, to kill the cancer.

Last week,we met with the fellow, Dr. Tim Caradonna, leading my oncology team and decided at each new setback we need to  discuss Quality of Life issues and decide if the treatment plan is worth it (Palliative care) or if we should stop treatment and focus on Quality of Life issues only (Hospice care).  

The challenge is I keep having brain mets that prevent me from using immunotherapy until the swelling goes down.  Our current plan is to do the Cyber Knife X-ray treatment to kill the current  brain mets and then use Avastin to reduce inflammation while tapering down on steroids so I can use the  Keytruda to kill any new mets. Avastin can be used with steroids (dexamethasone) and with Keytruda. The issue is whether the Avastin with a steroid taper will allow me to reduce the brain inflammation enough to maintain enough mobility to make the outpatient appointments

We're currently going to try following the plan.  For me that means eating well every day and trying to get mobile.

On Halloween 2025, I had an appetite and ate all of my breakfast.  I also had a good PT session and walked for 20 minutes with a walker and a cane, and walked up and down stairs.  So I can get from the curb to my wheelchair and this will let me take get a ride  to get to appointments.  One day at a time!

Yesterday, on November 2nd, I was discharged to my home, and its great to be home.
I had a nice sleep last night, and a delicious breakfast followed by PT exercises. Now I’ll take a nap from 9-11. This afternoon we will take an outing where I go down the stairs to the car, then we drive to look at leaves, then return home and I walk back up the stairs… We’ll do an outing every day to practice getting to the car and back! If problems with mobility arise I'll contact my oncology team, and temporarily increase the steroids.  

I'm optimistic about this plan as it will lead to systemic therapy with Avastin, to keep tumors from growing and reduce bran inflammation, and Keytruda, to kill the cancer.