The reason for the delay in the biopsy is to determine whether his treatment protocol is effectively reducing the tumor size.

It's not really a "culture" (in which cells are grown in a petri dish, such as staph or other bacterial or viral disease) as much as a pathology study of the tumor and it's reaction to the chemo.

If there is a response then the protocol is curative, if not then it moves to palliative.

For difficult cases the NCCN guidelines always recommend clinical trials.

An update, his oncologist heard my request to discuss chemo sensitivity testing and stated that the use of chemo sensitivity assays in not ASCO endorsed and nor would he condone a treatment plan based on its findings. Two other oncologists I've talked with have confirmed the same opinion.

Hmmmm - well if they at some point can't get a handle on it I would still have it done for now if chemo is helping and things are stable I would leave it, good luck!

Certainly, the oncologists cannot condone anything that isn't an approved standard of care. If it isn't a standard of care, it is a liability. Even going for clinical trials is, in essense, a standard of care.

I wish I could be of more help to you while you walk the "wait-and-see" tightrope. It isn't pleasant. Sending a lot of hugs, prayers, and positive vibes for you to find something helpful to move your dad from patient back to survivor.

My sentiments exactly sandy! And I agree that drs. Can't approve of anything outside heir "area of expertise" I know they are always worried about liability etc... But I also believe that without people out there who think outside they box - there would be little or no advancement. A lot of the time scientists just build on old work done by tried and true methods - his leads to some advancement - but sometimes you need to scrap everything and try something new - the problem with doing that is you have to be at the point of no return and no one wants to get that way when you are playing with people's lives. This personalized chemo/treatment to me sounds as if it does sit inside the venue of the "norm" it's not like you are discontinuing treatment - you are actually fine tuning it. yet it's still hard to make a decision like this because your father's life hangs in the balance... It's the - what if? syndrome that accompanies ths disease! It's not a decision I would like to make for fear of being wrong... Hugs!!! This is stressful. Hopefully he continues to be strong! And heal!

Thank you. Limbo describes this perfectly. Putting emotion aside is difficult. Facts are:
-the mets are small and the trial is aimed at keeping them that way as long as possible, if it works. If not, we likely move to the standard palliative chemo.
-Pursuing chemo sensitivity testing is an option I feel would need to happen now while he is "well" and yes, may open the door for decisions.
-His current oncologist will not support findings from the resulting report from such testing, which means we would need to work with a oncologist that would.

Pandora's box.