Decision log summary
The Treatment Phases
Oscar's treatments were prescribed, adjusted, held, or approved by my oncologist. This page is not a protocol to copy. Doses are described only as historical context, not recommendations.
| Phase | Treatment | Why it was used | What happened |
|---|---|---|---|
| Early waiting | Mitoxantrone — one IV dose May 1, 2025 | Needed treatment before molecular data returned | Single dose; then switched after DNA results |
| Molecularly informed chemo | Carboplatin (multiple treatments under my oncologist, including at least 5/22, 6/11, 7/3, 7/24) + olaparib from May 22, 2025 | Platinum + PARP logic fit BRCA1/DNA-repair weakness | Preceded strong bladder/trigone/urethra site response July 3, 2025 |
| PARP phase | Olaparib (with carboplatin, then ongoing oral strategy) | PARP logic fit BRCA1/HRR pathway | Became part of long oral strategy |
| Oral control | Palladia/toceranib + olaparib (Palladia added after carboplatin discontinued) | RTK/growth signaling + ongoing PARP logic; lung nodules to reassess after ~3 weeks on Palladia | Sep 4, 2025 thoracic rads: stable pulmonary metastatic disease; long middle; platelet monitoring mattered |
| Final targeted | Trametinib | NF1/MAPK pathway logic | Resting comfort improved early; movement pain worsened later |
| Discussed / Rx only | Sirolimus | TSC2/mTOR pathway logic from DNA map | Prescribed/discussed May 2026; never started — not administered |
| Comfort | Gabapentin, amoxicillin-clavulanate, amantadine, wound care | Pain, urinary inflammation, perianal lesion comfort | Became central near the end |
On July 3, 2025 — after multiple carboplatin treatments with olaparib under my oncologist — assessment showed a strong partial to complete response of the urinary tumor: my oncologist could not clearly visualize cancer on the trigone or urethra. Radiology language summarized mildly progressive pulmonary metastatic disease but almost complete resolution of the bladder tumor. That was a bladder/trigone/urethra site response, not whole-body remission; pulmonary nodules were still present.
By September 4, 2025 — about three weeks after Palladia was started — thoracic radiographs compared to July 24, 2025 showed stable pulmonary metastatic disease. Nodules were similar in number to the prior study and measured up to ~2.7 cm; several had a small air-filled / cavitary center (radiologist: may represent focal necrosis). A board-certified veterinary radiologist read the study. The treatment goal then became maintaining control while keeping Oscar himself.
Monitoring was part of treatment
- Platelet monitoring during Palladia/olaparib
- GI / bleeding / kidney caution with NSAIDs such as piroxicam
- Proteinuria / BP / kidney / appetite monitoring with trametinib
- GI monitoring with antibiotics and probiotics
- Sedation / mobility monitoring with gabapentin / amantadine
A cancer protocol is not just what you give. It is what you watch after you give it.
Related: method · DNA map · disclaimer