No news is good news. Is that what you’ve been thinking? Well, it isn’t exactly true that there’s been no news. And it isn’t true that there’s been no good news. After several dull months with Lee off his feet, things began to get exciting again on August 13th when I met my new oncologist. Was that a Friday? Dr. Sandler, a nationally renowned lung cancer specialist is the new head of the department of hematology and oncology at OHSU (Oregon Health & Science University) and I was assigned to his care when my previous doc retired last summer. After exchanging niceties with Lee and me and asking me how I felt (“Fine!”) Dr. S. surprised us with the word “Unfortunately…” My CT scan showed that a couple of lymph nodes had grown enough to necessitate further treatment. My cancer had “progressed.” That’s progress? I was shocked. I did feel fine and I had been doing so well. For almost a whole year my disease was stable, indolent --- it was history as far as I was concerned. But the scan showed that I was mistaken and something had to be done.
The doctor offered some options --- standard of care second line chemotherapy or perhaps a clinical trial. Over the next few weeks Lee and I learned a lot of new words --- Pemetrexed, Alimta, Cisplatin, Docetaxol, Cetuximab, Tarceva, Telactoferrin. Lee did a tremendous amount of research online and identified several clinical trials that I might be eligible to participate in. We went to see a Dr. Smith at NorthWest Cancer Specialists to discuss a trial he was running on a drug now known as ASA404. Dr. Smith said that before I made up my mind which course of treatment to pursue he’d recommend having my biopsy tissue tested for a certain genetic mutation. We knew from our own research that people who carry this mutation have excellent (yes, excellent) results from taking a pill called Tarceva, which blocks tumor cell growth by targeting the protein in your body called the Human Epidermal Growth Factor Receptor 1 (HER1/EGFR). It was a long shot --- only about 8% of the population have this mutation and they are usually Asian women who’ve never smoked. We said, “Go for it.” The results would be back in about a week and a half Dr. Smith said.
Ten days came and went. Eventually I began to feel not so “fine.” I went off on a week’s vacation and when I came home I decided that something needed to be done. After much weighing of pros and cons I told Dr. Sandler that I would take the Pemetrexed option. Since nearly a month had gone by with no results forthcoming on my genetic testing I’d pretty much forgotten about it --- like a lotto ticket I’d bought and stuck in my wallet. I was not excited about starting chemo again, but as anyone who’s been touched by cancer will tell you --- you do what you have to do. In my case I had to have a vitamin B12 shot a week before each infusion and take a steroid orally the day before, day of and day after the treatment, which was scheduled to begin on October 1st.
On Tuesday the 29th Lee hopped on his bike (yes, he’s hopping, biking and playing squash these days) and went to the grocery store for dinner supplies. The phone rang at 4:30 pm.
“This is Cathy from Dr. Smith’s office.”
Who is Dr. Smith? I wondered.
“We got the results of your genetic test and you DO have the mutation.”
I heard --- “YOU WON THE LOTTERY!”
When Lee got home I casually told him, “I’m a mutant.” After that message registered with him he flew back to the store to buy a bottle of champagne and two slices of chocolate mousse cake. (No, he can’t really fly. Yet).
So now I am a pill-popping, jig-dancing mutant with an excellent prognosis and possibly an acne-like rash.
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