Column: A Study in Contrasts

The decision for yours truly to participate in a Phase 1 Study at N.I.H. or Johns Hopkins (depending upon availability and qualifications) discussed in last week’s column has been put on hold, temporarily. It seems that my oncologist was thinking about me over the holiday weekend and called me on Wednesday following Labor Day to say he had a diagnostic idea concerning me: a 24-hour urine collection (a “Creatinine Clearance Study”) which would provide a more accurate reading (than the regular lab work I have; from blood) of my kidney function. Although the logistics haven’t been worked out—insofar as exactly how I get a sample to their lab—“the idea” as my father used to say, “has merit,” so I happily agreed in principle and awaited a phone call from my oncology nurse to explain the dos and don’ts.

Apparently, there is yet one more chemotherapy drug—of recent vintage, and design, that my oncologist would like to try. He hasn’t suggested its infusion previously, because like many drugs, it is filtered through the kidneys; and after four-and-a-half years of varying types of chemo/targeted therapy, (I.V. and oral) the damage to my kidneys—particularly as evidenced by my elevated creatinine level and below-average “glomerular filtration rate” (45 when 60 is normal) is and always has been cause for concern and caution. Collateral damage as I call it, is still damage, and renal failure/kidney dialysis is all it’s cracked up to be: not good, so diagnosis-to-date, we’ve avoided the risk. I’ve always agreed that since trouble has already found me, I’m hesitant to look for it. Perhaps there will yet be a reward for our prudence and patience.

Per the over-the-phone instructions I eventually received, I submitted my 24-hour sample on Monday morning. At 10:11 that evening, my oncologist e-mailed my test results. Although the colors were not flying, the test results were nonetheless improved, sufficiently so that we are indeed going ahead with I.V. chemotherapy once again. Therefore, for the immediate future, anyway, N.I.H. and Johns Hopkins are “back-burnered.” Alimta, the I.V. chemotherapy drug which I will be infusing, is my new best friend. A drug designed specifically for the treatment of patients with non-small cell lung cancer (me); every three weeks living forward, I will be infused at the Infusion Center. The entire process will take about two hours, I was told. “Two hours” I can do in my sleep, which sometimes is exactly what I do (the BarcaLoungers are extremely comfortable and the warm blankets are super cozy). So here we go, again. Nevertheless, it feels right.

 If I had been accepted into a study, my treatment would have been experimental and as much—if not more—about the next person. As it was explained to me by my oncologist, I would have been sort of a guinea pig, being injected with an experimental, non-FDA-approved medicine that previously had showed some promise when treating mice. I have no problem with this process and understand that such pursuits occasionally provide miraculous outcomes, and I’m certainly open to reconsidering should the opportunity present itself. However, going from a definite maybe at N.I.H to an FDA-approved for the treatment of non-small cell lung cancer drug seems like a no-brainer, even for me. Granted, I’m still a long way from anywhere, but it feels good to be back in the game, rather than being on the sidelines, sort of (with all due respect to N.I.H. and Johns Hopkins).

My future is now and thanks to this most recent diagnostic test, my treatment with Alimta can also be now; Friday the 20th, actually.