So I had been on Tarceva for 18 months and doing great. Attababe, congratulations to me! But a little voice told me that one day Tarceva will meet resistance from the smart cancerdude. Hoping that the little voice was off its rocker, I asked my Onc, who also has lung cancer, what he thought. “Oh, definitely, you will have resistance — if you live long enough!” my Onc assured me. I told him I needed his assurance like I needed a biopsy atop the aorta. And we roared in laughter. Then with the next CTscan came the tiny, tiny progression. The question, To change or not to change treatments, stared me in the face. If it were you, what would you have done?
“Talk to your Onc.” That’s what people will probably tell you and they should. What will the Onc tell you? He’ll probably give you a couple of options based on (a) his education, (b) his experience, and (c) his opinion.
“Talk to another Onc.” Other people will probably tell you. It’s another way of suggesting that you to get a second opinion. What will the second Onc tell you? He’ll probably give you a couple of options based on (a) his education, (b) his experience, and (c) his opinion.
“Talk to Celia.” You knew that was coming! I am not an Onc, therefore I will not give medical advice or any advice that will affect anybody’s wellbeing, like, ignore those symptoms; they’ll go away. But I might say, Use Philippine coconut oil. It’ll make your skin soft and silky. Feel mine. LOL. I would never, ever tell anyone to lower or increase dosage of any drug. What I am is a blogger who has lung cancer, a colorful past, and more opinions than the OpEd page of New York Times. What will I tell you? I’d probably give you an opinion based on (a) everything I’ve learned from Google University, (b) everything I’ve heard first hand from Oncs and (c) my awesome life experiences that apply.
From the Google University, meaning, from Inspire.com and cancergrace.com, etc., here is one very good link that can help you decide on which option to take.
So now, after talking to one Onc or two Oncs, and reading another Onc’s blog, you have more questions than answers. It’s decision time and your Main Onc gives you options.
This was my situation. After I bombarded my Onc with Tarceva resistance questions after every CTscan, he finally threw in the towel. I wore him out. He said there’s no more drug in the cancer medicine cabinet. He mentioned Afatinib, recently FDA-approved and which had been groomed as the Son of Tarceva. My husband and I shot that idea down because of the negative things we’d read about it. Finally, in exasperation, he said, “I’ll refer you to my Oncologist. If he’s good enough for me, he should be good enough for you.” I liked that.
So I met my Onc’s Onc, whom I bowled over with my Tarceva Diva title of the moment. After looking at my case history, he said my tumors were the very-slow-growing type, then gave me three options: (a) Stay on Tarceva, (b) There’s always chemo, and (c) If I qualified, he’d put me in a clinical trial. Without hesitation I chose (c) clinical trials.
Here are the reasons why I chose (c):
(1) Honest Auto-Criticism. I could have just said I was being honest with myself but I woke up this morning with a crying need to impress. In the final analysis, only the patient knows her worries. The Onc has worries of his own.
(b) Opportunity. In life, we get certain windows of opportunity. If we don’t act within that window of opportunity to solve a problem, we might as well kiss the solution goodbye. To me, dealing with a disease is similar to growing a business. A business goes kaput if suddenly there are no projects for employees to work on or no merchandise on the shelves to sell. The time to look for projects or merchandise is not when they’ve run out. Same with cancer, I acted pro-actively. I read about people running around like crazy looking for clinical trials while there I was, being given a clinical trial as an option. Why not take it?
(3) The pioneering spirit. It jumps like a pogo stick inside me, pushing me to the path not taken.
The jury is still out on my decision, but I stand by it.
That’s the word today.
What say you?