It’s Called The Second Line

April 28, 2017

This week it was officially decided that I would/could not wait for the insurance company and drug manufacturer to get on the same page with Afatinib.  Even though my pleural pain had not gotten worse, it had also not gotten better and so we move on to the second line of treatment which is Cyramza and Taxotere. Both names sound like they could be used in the next Hunger Games sequel.

This is what I have learned:

Cyramza is a fairly new biologic drug called a monoclonal antibody, a new type of ‘targeted’ cancer therapy. I quote here from my 2 page handout: ‘Antibodies are an integral part of the body’s immune system.  Normally, the body creates antibodies in response to an antigen (such as a protein in a germ) that has entered the body. The antibodies attach to the antigen in order to mark it for destruction by the immune system….Since monoclonal antibodies target only specific cells, they may cause less toxicity to heathy cells. Monoclonal antibody therapy is usually given only for cancers in which the antigens (and the respective antibodies) have been identified already.” And to paraphrase the next 3 paragraphs, solid cancer tumors cannot grow beyond a limited size without an adequate blood supply and because this drug inhibits/blocks the action of VEGFR-2 (vascular endothelial growth factor receptor-2) it basically starves the tumor by cutting off its blood supply.

Taxotere belongs to a class of chemotherapy drugs called plant alkaloids. Plant alkaloids are made from plants…don’t let this fool you, some plants are poisonous. This is how Taxotere works: “Antimicrotubule agents (such as Taxotere), inhibit the microtubule structures within the cell. Microtubules are part of the cell’s apparatus for dividing and replicating itself.  Inhibition of these structures ultimately results in cell death.”

Side effects are varied but I have been assured that the remaining 2/3 of my hair could fall out. How vain am I ??? I guess I’ll find out. As I told my hair follicle challenged Dad over Easter, “If I have inherited your head shape, I’m in deep trouble…”. In the mean time, Stacey and I preemptively found a great wig 🙂 Prayers please that I won’t be in the small percentage of those who experience permanent hair loss, that would be another lesson altogether.

I am going forward with the appeal process necessary in hopes of still being approved to try Afatinib. In the interim, I fully anticipate that this new protocol is going to slow down/stop the cancer from growing and allow me to enter the NED phase (no evidence of disease). Like before, I get this combo every three weeks and will have at least 2-3 cycles before re-scanning. My nadir (meaning low point) is between 4-9 days after treatment. This is when I experience low blood counts and the majority of side effects. It’s supposed to snow this weekend so hibernation will be much easier, plenty of soup on hand and my trusty caregivers at the ready.

And so my journey continues. I am grateful that Dr. Narayanan and Dr. Camidge confer with each other on my medical treatment. I continue with my complementary treatments and overall I am feeling pretty darn good.  There are many wonderful things happening in my life and I continue to look for and find the joy in every moment. Today, I am still in my pj’s at noon….life is good!

Thank you for your continued prayers and good thoughts.


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