Tuesday, October 20, 2015

Targeted therapy. WHAT??

 Congratulations!! I passed the genetic tests! What the heck you and I are both asking, right?
Well, I've learned a little about all of this, but it's so foreign to me that I'm still overwhelmed at this point. They are telling me that my chemotherapy ride has been cut short and I now qualify for targeted therapy treatment. Yay??

What in the world is targeted therapy treatment? I have found that most people don't even ask. Their head turns a little sideways when I tell them of my treatment and I can see the wheels are turning, but no. It does not compute.

Cancer treatment is supposed to mean that you go in to the oncology department once a month or so and get hooked up to an IV full of poisonous hardcore drugs known as chemotherapy, right? Then you go home and get sick for a few days or week and then you're better until you're next treatment. You loose ALL of your hair, are usually pale and get those dark sunken eyes. That's just not how it usually is in the real cancer world! I know it's difficult for everyone who thought they knew anything about cancer and especially it makes it so much harder to detect the people who are sick!! I look gook, well, I look ok, so I must be doing well, right? N0, not right.

With all of the new discoveries and new treatments available, the face of cancer treatment has changed. Don't hear me wrong. There is still a multitude of infusion chemo treatment going on out there. It's still a viable source for treating and helping cancer patients. The thing is; there is so much more now and it's a good thing!

What is targeted therapy treatment, you ask? Oh! I'm so glad you asked! Let me tell you about the wonder drug that I take for non-small cell lung cancer. Ok, so I won't tell you everything. I can get started and it's so very interesting to me it's hard to stop, but I know the average person just wants the short list.

It starts with the way they are able to do genomic testing today. Which is wonderful  for the fight against cancer.  That in itself is sooo very exciting. Especially for someone like me who has a specific cancer cell that has gone haywire, mutated from a normal cell into a bad cell and caused all of this in the first place. What?? you can get lung cancer if you don't smoke, you ask? Yes! If you have lungs, you can get lung cancer.

What's genome, you might ask? Genome is the full set of chromosomes or all the inheritable traits of an organism. Simply said, it's genetics. So, they know how to test the genetics of the cancer cell now and there are a handful of specific mutated cells that have been identified and they were able to create a particular medicine to fight it. This process is called a "targeted therapy". The medicine targets those specific cells as bad cells and kills them. You might think, great! You just do your 5 months of treatment and then your cured? Well, it's just not that simple. As we know, cancer is this thing that very seldom really goes away. We all know someone who was diagnosed cancer free after there treatment to only find out some years later that it's back again. My belief is that it never went away. It laid dormant in the body somewhere, maybe just one tiny minute cell, until it gained enough strength and reproduced or even mutated into another deadly army. It is just like your worst enemy. Actually, it IS my worst enemy!

Okay, okay.. I promised the short list. First of all, every single cancer is different and is treated differently. Every patient is different and should be treated individually. There are many different targeted therapies out there and many more still in clinical trials. It depends on which cell has been affected. My type is known as EGFR positive. The E stands for epidermal meaning that my skin is involved. It stands for Epidermal Growth Factor Receptor. The E part is so important. The drug I take is called Tarceva (that's the easy name to pronounce) and it causes a multitude of side effects in all areas of my epidermal constitution. They say that's how you know it's working, but I'm not so sure about that. 

The good thing about this treatment is that it comes on strong to reduce tumor size, works hard at immobilizing any active cancer cells and usually does this fairly quickly. The bad news would be that you have to take the drug every single day as long as it is working. If you stop all of it's hard work would be undone and the cancer would be able to reactivate and grow quickly and even spread with it's new found strength. My oncologist said about 10 times at one of my appointments, "Take your pill everyday." This was the appointment at about 3 months of this therapy where the CT scans showed that the tumors were nearly gone. I guess he didn't want me to go out and celebrate by taking vacation to the beach and taking a vacation from my chemo medication. Sadly, that's been done.

You now know almost as much as I do about this new cancer treatment called Targeted therapy.
Well, everything except the details of the horrible side effects that began within days and nearly drove me to the edge, but about that time my body began to adjust and it's not quite as extreme.
I still deal with daily side effects, or "special effects" as those on Tarceva like to call it.

Even with all of the side effects raging through my body I'm extremely thankful to have been able to be on this type of treatment. It's truly a wonder drug and I'm thrilled to now be considered in remission. There is no sign of cancer activity and my tumors are mm sized. My last Pet scan was beautifully "unremarkable" as the radiologist stated in the detailed report. A statement I will embrace and look forward to hearing again. Unfortunately, this treatment has a bad reputation for only working for one to two years. As soon as we have signs that it's no longer effective it will be back to the drawing board or rather the testing sites to find out what the next regimen will be. Until then, I'll embrace life; love my loved ones and make sure they know it, live as though there is no tomorrow and do the things that have meaning. No one knows how long they have on this earth, but I'm learning to deal with the statistics that I've been given and make everyday count. I hope you do the same.