Second Line Therapy

The past few weeks I have tried not to think about going back to my oncologist.  It was just a very wonderful time being off the drugs.  I was able to sleep, eat, had energy and felt as close to normal as I have been since last summer before I became ill.

So, I am sure you can empathize with me when I walked out the door to leave for Greenville. I had a lot of things that I would find out today.  As I got to the end of the drive way, I could feel my blood pressure going up.  Know that sounds crazy, but it was real to me.

John had some things to do at work, so he met me at the doctor's office.  We were taken in right away and went through the normal drill, get my blood work done so the doctor will have the information when we talk.  Four large vials of blood were taken and quickly sent to the lab via a little special "suck" tube like the ones you see at the bank.  Put them in and swoosh, gone.

Shortly after that, Austin, Dr. Mahajan's nurse, was at the door, smiling as always and ready to get the next information that would be needed before meeting with the doctor.  First my weight, told you I had been eating better.  Old porky here had put on 6 pounds in the past few weeks.  But that was a good thing cause it will probably change soon.

My blood pressure was still up, but not as high as it was on the last visit, but still high enough for me to be concerned.

Dr. Mahajan came in a few minutes later.  He is always smiling and in a good mood. He asked how I was doing and I told him, "I had a great few weeks and would be even better if he had good news for me."  He smiled and pulled up my info on the computer.  Good news, all my blood counts were back to normal.  That was very good news, because as you know, if the counts are too low, I would not be able to continue the treatment.  Next, on to the treatment information.  He had tried to get samples from the biopsy taken last fall, but unfortunately, it had already been divided too many times.  He called Mayo Clinic and their samples were not available either.  So, we may have to do another biopsy to get additional tissue.  Not looking forward to that procedure.  It was probably one of the most painful of all the things I have had done so far.  The doctor had to enter via my spine and guide the needle down to the growth and clip tissue.  This is all done while under mild sedation....emphasis on MILD here, and while using an ultrasound guide to make sure he is clipping the right thing.

Anyway, on to today's treatment.  Initially, I was on what was called first-line treatment - the first move to attack the cancer.  The drugs were chosen carefully after Dr. Mahajan assessed my medical situation with me and the Mayo Clinic.  These are usually the drugs that would give the greatest response and move the healing forward.  And, it works for most people, unfortunately, that was not the case for me.

Just as every cancer is unique to the individual, treatments and responses are the same.  One type of therapy will act differently on different people and that's why some of us must go through more than one therapy before the most effective treatment is found.  John's question to the doctor, "Did the chemo I was on help any?" His answer, "We don't know, we can only speculate on that. All we know is, it didn't stop or shrink the growth, so we must move to another treatment."

The CT scan and MRI indicated slight growth in the tumor, so a different therapy was needed.  With the change there is still good reason to be very hopeful.  From what I have learned, there are excellent second-line therapies that produce better responses for many people.  But it was difficult.  Being told all that you have been through didn't work.  I guess the best part of the change in chemo drugs was taking the one that caused so much cold sensation off the table.  That was a tough one to deal with.  Nothing cold, everything room temperature or warm, no ice cream, no ice tea, nothing....and if it was the least bit cool, it made my throat feel like I couldn't breathe.  Plus, it made stuff taste bad.

My understanding is that second line does not mean second best.  A lot of patients have to switch treatment to get good results.  Sometimes a third or fourth time.  But luckily, there are new targeted therapies, with fewer side effects.  A KRAS test (which is due to advances in biomarker research and is a new molecular test of the K-ras gene) can provide information on the likely hood of a drug working.

So, I begin the new drug regime.  It will be administered with some of the same drugs I was previously given.  Still get anti nausea stuff, steroids, all mixed into the witches brew.  Then after about 5 hours in the drip chair, they put on my travel pack for the final drug that has to be administered over 46 hours, so I will go back on Friday to be "unhooked".

Wagon is still rolling.....
PCQ