October 23, 2020 – This afternoon, I completed my second round (infusion) of Keytruda (pembrolizumab) at West Cancer Center’s main campus. Keytruda, as I’ve explained previously, is an immunotherapy medicine – meaning it boosts the body’s natural immune defenses in order to fight cancer.
My new treatment regimen is based on science, real science. Not conspiracy theories, not voodoo doctors who believe in alien DNA, not off-the-cuff comments about drinking bleach to kill a virus. Real science.
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| Up the steps to the unknown. |
Immunotherapy treatments are relatively new. Keytruda was FDA-approved in 2014 and by 2017 was in use for solid metastatic tumors, like melanoma. The U.S. approval and testing process is long and somewhat complex. Clinical trials can take years to complete.
I volunteer my time by working on scientific review panels that evaluate research proposals for possible funding grants. I’ve been a part of this process for a couple of years now, and it is a tremendous honor to be a “consumer advocate” and share my impressions (and concerns) with cancer doctors and researchers. This is one of the many ways I give back to the melanoma (skin cancer) community.
I want to ensure that melanoma prevention and treatment moves forward towards a potential cure and the funding of this research remains apolitical. Scientists need to be able to do their work – without threats and without undue influence.
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| A long day. |
Although the Keytruda infusion typically lasts only thirty minutes, my October 23rd visit was over three hours. Blood work, IV insertion, oncologist visit, scheduling (and re-scheduling), waiting on lab results, pharmacy prep work, a flu shot – all took place before my infusion.
Sitting in the third-floor infusion area was both odd and sad. Memories of waiting in this area while Emily received her chemotherapy treatments brought a flood of emotions. I’ve been a stage IV cancer patient for a long time, but I’ve never had intravenous treatment. The infusion area is a dull, sterile environment. It’s sad watching folks from all walks of life undergoing treatment. We have one thing in common–however–we all have cancer.
At the same time, watching other patients hooked up to IV machines and monitors reminded me that we’re fortunate to have researchers, scientists, technicians, nurses and doctors working hard to find new and better treatment options and, maybe one day, a cure.
Real research. Real progress. Not just talking points during a political campaign.
Real science.
Thanks, as always, for listening.
While, initially, this news was distressing, it didn’t come as a complete shock. All summer, we’ve been wondering what caused the sizable blood mass in and around my adrenal gland (see Doctor Doctor…). Now we know. Melanoma some how made its way to another part of my body.
Frankly, since early June, I’ve expected this outcome. It’s the reality of living with cancer.
With this sad news comes several positive developments. First, the PET scan (see The Waiting…) was negative for any additional cancer spread. That’s important because we want to keep the cancer contained as much as possible. In other words, right now, only two places inside my body have malignancy – my lungs and my right adrenal gland.
Second, the metastases around my adrenal gland, according to biomarker testing, contain the same genetic mutation (cKit) as the tumors in my lungs. That’s also important because we’re only dealing with one type of cancer (again, see The Waiting…).
Which leads to another (hopefully) positive development…we will continue my current treatment regimen – daily oral chemotherapy medicine (Gleevec) – with a new component: radiation therapy to tackle the adrenal gland.
This post will be short and sweet. Many things are coming together even as I write this. I’ll provide more details in a follow-up post (Another Twist, Another Turn).
This is yet another twist and another turn in my melanoma journey. I’m confident the journey will continue for many years to come.
I want to thank all of you who have made this journey with me. Your thoughts, your prayers, and your concerns are greatly appreciated. I’m absolutely humbled by it. Please focus your thoughts and prayers on Vicki, Emily, and Zach as they have been my guiding light in this crazy storm. In addition, prayers would be appreciated for my dad, my sister, my sister-in-law, and my entire extended family.
Thank you.
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| A thoughtful gift from Vicki’s true friends. |
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After four weeks of treatment, I’m actually feeling pretty good. I saw my doctor last week (on September 11th), and he said that it’s not unusual for patients to tolerate Gleevec (my oral chemotherapy medicine) with only minimal side effects. Most of my initial side effects have seemed to wane, and I’m hoping that is a good sign. My blood and glucose levels were normal or, at least, in the acceptable range. Now, I will be on this medication for about another thirty days.
On October 9th, I will have a CT scan performed. We will immediately look at the results that day to determine if my tumors have grown or stayed the same. My doctor did tell me that it typically takes 3 to 4 months for tumors to shrink when treated with Gleevec. So, what we’re hoping to see is that my tumors have not changed or grown. I’m glad I have people much smarter than me monitoring my cancer. It’s a blessing to have some many folks “in my corner” as I continue my journey with melanoma, which brings me to today’s thoughts on being watched over.
Spending a lot of time at home has been both a blessing and a curse. Luckily, I have not had to endure being at home by myself. I have a shadow – literally – who follows my every move. Nixie, our six-year-old Border Collie has always been my constant companion. Now that I’m home more, it’s a given that I will be continually watched over or “guarded.”
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| Who’s watching over you? |
If you know anything about Border Collies then you know that they are highly intelligent, extremely focused dogs who fixate on their work with the intensity of a sixteen-year-old video game fanatic. These dogs also have boundless energy and a fervor for completing a job that would make any office manager jealous. Prior to last month, Nixie’s “job” was to chase balls and catch Frisbees. As long as Nix – as we call her – was busy then everything was fine. If we didn’t keep her busy, or give her enough exercise, there was “heck to pay.”
Now, her job is to watch over me…at least that’s what she thinks she is supposed to do. Nix is almost always by my side while I’m at home or outside in the yard. When I return home from running errands or from an appointment, she greets me as though I’ve come back from a long journey. I know most dogs are like this, but Nixie’s intensity has seem to grow ever since my diagnosis. Does she sense that something is wrong? Is it true that dogs can tell when their owners are ailing? I don’t know, but I do know that I’ve got a four-legged family member in my corner as I deal with my cancer.
In fact, I would think that everyone would want to have someone or something watching out for them. Whether or not you’re a spiritual person, there’s something comforting knowing that you’re being watched over…even if it’s a sometimes neurotic, always attentive thirty-eight pound fluff-ball.
And the journey continues…..