Latest Scans Show Good News, Bad News
So Dena and I went to Baltimore this morning for a new round of scans. We have finished the second cycle of MDX-1106, and we were anxious about this scan as we were told it would be a better indicator than the first as to whether the drug was working – since immunotherapy takes time to kick in. When my doctor came in with the radiology report, he said he had some good news and some bad news.
“What’s the good news?” I asked.
“Your cancer is progressing.”
“My god – what’s the bad news?”
“These lesions on your shins are getting worse.” I looked down at the lesions, which were red and inflamed, a byproduct of the MDX-1106 when it mixes with sun. I had been out in the sun too much during the U.S. Open.
“But how is my cancer progressing good news?”
“Are you not listening to me? Your shins are hideous. Chicks will never dig you with freaky legs like that.”
He had a point. And I’m getting ready to go on vacation – down to hot hot hot Savannah, where we’ve got a beach house and where I plan to play plenty of golf. My legs may disintegrate in all that sun. Perhaps I could take on the identity of a 70-something and wear khaki shorts and long black socks stretched up to my knees. Get a metal detector and scour the beach for coins and soda can tabs.
So, anyway, about this cancer thing. Dena and I were disappointed with what we heard today. All of the tumors have grown to some degree or another, and a new lymph node has become involved as well. We discussed the options available to us with Dr. Hammers. We could drop out of the trial and try to enter a new trial that is testing the use of Sutent and Avastin together. Sutent is one of the most-prescribed drugs for kidney cancer. The problem with Sutent is that eventually it quits working. Also, even when it is working, you take four weeks of doses and then take a two week break and then go back to another four weeks on and two weeks off and so on. The breaks are necessary because the side effects are pretty tough, and the body needs time to recuperate. During this two-week break, however, the mets start growing almost immediately. The Sutent/Avastin trial seeks to stop that growth in between Sutent cycles by having the patient go on Avastin during the break. Avastin does not have the same kind of side effects and is more easily tolerated that Sutent. (They tried combining Sutent and Avastin together in one dose but the toxicity levels of the two together was too high.)
Dr. Hammers, however, made the case for not giving up on the MDX just yet. While we’re not happy about disease progression, the “tumor burden” is not so great that my body can’t handle it right now. I’m still feeling good. As noted previously, immunotherapy can take time. He recommended we stick it out for one more cycle and see if we get results. After that, if we see more progression, then we can consider other options. If I leave the MDX-1106 trial now, I will not be eligible for any other trial involving the drug, so this is my only chance to see if it will work for me.
Dena and I both agreed with Dr. Hammers, and so we decided to stay on the trial for at least one more cycle. However, we did like the Sutent/Avastin concept of cycling on the drug and cycling off with something else, so we’re putting together our own plan of one week on MDX-1106 and one week off with an all-you-can-drink-jagermeister marathon karaoke session, one week back on MDX, another karaoke binge, and so on. Just leave a message in the comments section if you’re in.