The New Plan: Sutent
With the failure of the lung surgery, and the new progression in my lungs, Dr. George is recommending Sutent. Sutent, as many of you know, is the wonder drug of metastatic kidney cancer (or, as those of us in the know like to say: mRCC.)
I am told the side effects aren’t pleasant. While Sutent might not be especially pleasant, at least it’s not IL-2. It doesn’t require intensive care. It doesn’t even require an IV infusion. It’s a just a pill, a very expensive little pill. You can read about its side effects here, if you are so morbidly inclined – and who isn’t?! As with my approach to life in general, though, my approach to Sutent’s side effects is to studiously maintain an intoxicating ignorance; ignore the list of them and blithely assume they are for other people. Seriously. When Dr. George started going over the list of side effects, I suggested he skip it and move on to the good part.
While Sutent has been known to result, in very rare circumstances, in what’s called a “complete response” – meaning to have eliminated all evidence of disease – more common is to see tumor shrinkage and stabilization of the disease. It’s a systemic treatment, meaning that this treatment will attack the cancer throughout the body wherever it might be.
For those of you familiar with Sutent and its cycles, Dr. George recommended that we start with a four-week on, two-week off cycle of 50 mg. For those of you who aren’t familiar, the drug is administered for a month and then you take a half month off to recuperate from the toxins and side-effects, then dive back in.
Dena and I walked out feeling pretty good. We have a plan in place, and we’ll be attacking the disease with a systemic treatment that not only has the potential to push back the mets we know of but also possibly eliminate smaller ones we don’t.
The only truly disturbing moment occurred when Dr. George recommended that we start with 50 mg of Sutent and Dena asked if that was the maximum dose.
“Yes,” Dr. George said. A pause. “Well, no. It’s generally the maximum dose. Some have gone higher, to seventy five, but I don’t recommend you start there. Fifty milligrams is often too much for many patients and we have to scale back from fifty, so let’s start there.”
“Whatever. We’ll start at the top, or we won’t start at all. Do you think my man is a sissy?” She slapped my face. “See that?”
There was an awkward moment, but Dan held his ground. Bless him.