Column: Been There, Doing That

Column: Been There, Doing That

I.V. chemotherapy, that’s what; and I’m not infusing it for the fun of it, either. I’m infusing it for the potential tumor-shrinking effect of it. It’s not my first choice, to be infused, but after four-plus years of miscellaneous treatments, it is one of the few remaining choices I have left. I’ve had a good run of success though, diagnosis to date; especially considering that it’s been 11 months since my last infusion. Since then, it’s been a pill a day, 150 MG of Tarceva, which has indeed kept the doctor away. No fuss. No muss. Now, there’s likely to be fuss and muss. It’s nothing I haven’t experienced and dealt with before – being infused – so I know the drill. The outcome, of course, I don’t know.

Not that I’m looking forward to the treatment: three weeks on, one week off, etc., but looking backward serves no particular purpose and certainly offers no guarantee of future success. Tolerating the previous infusions as well as I have bodes well, as does my overall good health. However, if I’ve learned anything in my cancer journey, it is that oncologists, generally speaking, are not in the predicting business. Projecting maybe, but not so much that it anticipates a scenario worth planning for. The process is not exactly wait and see, it’s more like treat and see – via the next scan; the anxiety concerning which has been well-chronicled in this space over the past month or so.

And sure enough, the results from this most recent scan were a bit discouraging. For the first time in nearly a year, growth, “slow growth” was apparent (and as my father used to say: “Any way you slice it, it’s still ham.”) In the cancer business, when the tumors grow after not having grown previously, it generally means the treatment/medication is no longer effective; it’s like a tipping point. Therefore, change is necessary. My change is to restart I.V. chemotherapy, and restart with a drug with which my body has not previously been infused and with which the cancer cells are not familiar. Another cancer fact I’ve learned: once the cancer cells become acquainted, shall we say, with their chemical adversaries, they fail to respond as hoped. Moreover, once the cells have been exposed/treated by a particular drug/cocktail of drugs, the treatment becomes progressively less harmful to the tumor and in turn more likely to cause collateral damage to the patient, making future treatment options challenging. Outliving one’s prognosis is wonderful. However, it is akin to – if I may use a football analogy – outkicking your punt coverage: protocols for patients who significantly outlive their prognosis are, unfortunately, few and far between, given the available patient population.

In addition, I’m limited by the irreparable chemotherapy-caused collateral damage I’ve already experienced. Still, I’m hopeful (25 percent so, as I’ve been advised by my oncologist). But I remain positive about this new negative. Diagnosis to date, I’ve responded better than expected to every previous similarly-necessary treatment change I’ve faced; and other than the reality of the situation, I have no reason to believe otherwise infusing forward.