Decisions, Decisions, Decisions…

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Writer’s Note – I’ve been on an extended hiatus for well over nine months.  So, I first want to say “Thank You” to all of you who continue to stop by and check out my blog.  This blog and several to follow have been accumulating in my head for quite a while.

March 2015 – The latest word from my oncologist is that the largest tumor – in the very upper right section of my right lung continues to grow, albeit very slowly, and the tumors in my left lung have stayed relatively the same size (he thinks), but there is one – in the lower left lobe – that has “changed” from the last set of scans.  Needless to say, we’re at a crossroads in terms of my treatment regimen.  There are several options to choose from, and none of them may make a significant impact on my present condition.

Option 1 – We do nothing and continue with the Imatinib.  My oncologist is not keen on this option because he thinks the medicine has done all it can do (which is good), but my melanoma may be fighting back and, possibly, starting to win.

Option 2 – We try a new drug regimen either with or without the Imatinib.  The new drug, Dasatinib, is primarily used to treat certain forms of leukemia.  It is a “kinase inhibitor” (whatever the hell that means), which puts it in the same category of drugs as Imatinib.  The idea, according to my doctor, is to supplement my current drug with a newer “version” that may help stem the growth of my current tumors.  Unfortunately, the insurance company did not think adding another costly cancer drug was something that they want to pay for, so the idea was nixed.  (My oncologist said he could write a letter to the insurance carrier to appeal their decision, but we decided to look at the other options, first).

Option 3 – The final option was to ablate the larger tumor in my right lung.  Ablation essentially means to vaporize or burn something.  In my case, a cancerous tumor.  There are three key types of ablation treatments: radiofrequency, microwave, and laser.  According to the Mayo Clinic’s website, radiofrequency ablation for cancer is a minimally invasive procedure that uses electrical energy and heat to destroy cancer cells.  Basically, they would stick a needle in my lung and “zap” the tumor with heat.  Ugh!  I was not too thrilled to hear about that option.

So, after meeting with the oncologist on March 19th, we decided to “punt.”  We asked him to get us a second opinion.  His initial response was sort of defensive, but, then, he bought into it.  Our biggest concern was for me to undergo a possibly difficult procedure, which may prove unnecessary and, worst of all, not make any difference.  The doctor agreed to consult with some melanoma experts and put my case in front of their “tumor board,” which meets periodically to make decisions about patient treatments.

No doubts about what’s inside.

Later in March we followed-up with the oncologist, who told us that the board and the melanoma “expert” (a researcher at the University of Pittsburgh cancer center) both agreed that we should “stay the course” with my treatment.  I have another CT scan scheduled for May and my annual PET scan is due in July.  It was both a relief – I don’t want to be “burned” – and a victory in terms of feeling control over my situation.  Just knowing that other doctors and experts are being consulted made me feel less isolated.  Eventually, we’ll have to make some major decisions about my treatment, but I want to make certain all “easy” options are exhausted before we move to next level.

As always, thanks for listening.

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Not that I needed to be reminded that my situation is a serious one, but the company that makes and sells my cancer drug, Gleevec, (aka Imatinib) has begun to package my meds in a yellow “transport bag” that leaves no doubt that I’m dealing with some serious stuff.  Just another not-so-subtle reminder that I’m dealing with some serious stuff.  It is sometimes hard to remember that when I’m living a somewhat “normal” life (whatever that is).

The drug company also started us on a discount program in which we receive my meds at almost no cost – about $30 for a 90-day supply.  The drug company calls it a financial assistance program and part of their “patient advocacy” initiative.  I think it’s because I’m a human “lab rat” and as I continue to live by utilizing an experimental treatment, the company will be able to sell more of its product to other cancer patients.  I guess I’m being cynical…whatever the reason, I’m glad for genetic testing.  That’s what it truly keeping me alive.

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