My CO-1686: A “Dear Celpeggy” Letter From Norway

One overcast day last month, while I was quietly meditating on my navel on the bedroom floor, a little voice told me to look at my blog on the smartphone perched on my lap. Sure enough there was a notice about a comment.

A gentleman named Lars in Norway wrote a comment at the end of my one-year anniversary blog post. What can be more Norwegian than the name Lars? It reminds me of Phyllis’ never-seen husband in the popular TV sitcom Mary Tyler Moore Show of the 70’s. But reader/writer Lars is a live one! His letter is complimentary and contains links to valuable information. I consider it a blog help that literally fell on my lap. It happens when the blogger is a self-professed amazing woman.

I am printing Lars’ letter here in its entirety because I am sure the links will be of interest to other followers of this blog. But first, I must confess that I entertained the notion of tossing a few superlative flattering adjectives in praise of Celpeggy in Lars’ letter but I decided against it. I remembered humility is a virtue. Second, please be reminded of the mother of all disclosures: My opinions expressed in this blog do not constitute medical advice. I am not a physician, nurse, midwife, dentist, medical technician or any health care professional. What I am is a retired professional engineer – a civil engineer – whose main focus during my productive years was ensuring that the water line was not connected to the sewer line. There you have it.

Here is Lars’ comment as is:

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Dear Celpeggy,

first of all: thanks for a very good and fun blog. My wife (who is from Singapore) was just diagnosed with same as you (stage 4 lung cancer) and reading your story both provides hope and laughter.

The reason I came across your blog was that I googled “metformin and erlotinib”. I have seen some research that indicates that metformin reduces both cancer risk and improves survival. Here is e.g. one article: http://www.ncbi.nlm.nih.gov/pubmed/25267165.

I have also seen an article that specifically looks at metformin in combination with erlotinib: http://www.ncbi.nlm.nih.gov/pubmed/24644001.

Would you have any thoughts on whether combining metformin with erlotinib could make sense? I am aware you have tried it in combination with CO-1686 which is not the same as erlotinib, but thought I might ask anyway 🙂

Again: thanks for a great blog and best whishes from Norway!

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I wrote him back:

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Hello Lars,

Pleased meeting you (and your wife) here although I must say a barbecue at the beach would have been a more pleasant venue.

The answer to your question is: I agree. Metformin and Erlotinib would be great together – Erlotinib as the treatment and Metformin a supplement. I wrote a post about Metformin twice. Please look at the archives, if you haven’t done so yet.

I loved your comment. It contains valuable information and links that other readers can appreciate. Unfortunately a majority of the followers do not read the comment area. Would you mind if I use part or all of your comment in a future post crediting you as the source? This way we can help other cancer sufferers and caregivers. Please let me know.

That’s a cute baby you have there. No young mother or father should ever have cancer. I hope your wife continues to do well on Tarceva but if not, there’s the CO-1686 which should soon be an approved second-generation lung cancer treatment.

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He responded:

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Hi Cella,

you can of course use any and all I write in future posts 😉 I found some more information I found regarding metformin. First of all two trials testing it out:

-metformin and gefitinib as first line treatment in China for patients with EGFR: https://clinicaltrials.gov/ct2/show/NCT01864681

-metformin and erlotinib as second line treatment for patients without EGFR: http://www.sciencedirect.com/science/article/pii/S1525730414001466

And one more study showing an increased survival for diabetes patients who use metformin and have lung cancer: http://www.ncbi.nlm.nih.gov/pubmed/25522257.

I am guessing the trial from China soon should have some results out, even though I am very far from being an expert on these issues… If you want, I can also send you the full articles from the above links.

And yes, it would have been much nicer to meet at a barbecue 😉 If you are ever in Norway, let me know and we should do a barbecue!

Best,

Lars

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In conclusion:

(a) Thank you, Lars, for sharing great links to information about future cancer treatments.

(b) Flying to Norway to enjoy a backyard barbecue suddenly became a distinct possibility for the social butterfly!

My CO-1686: Year Two Opened With a Bang!

My CO-1686 Clinical Trials One-Year Anniversary celebration rocked the whole month of March. The Inspire Party Bus rolled in twice. The rowdy riders sang and danced wildly, bottles of drink in hand. Unfortunately, I had to refuse their clamor for my pole dancing. Hey, I was a proper host who had to keep decorum. Speech! Speech! They chanted in unison as they banged the sides of the bus. I obliged. I bragged about my blog having been nominated for “A Lovely Blog Award” by fellow warriors/fun writers Dann Wonser http://www.dannwonser.com and Craig Blower https://craigblower.wordpress.com. A thunderous applause followed. Then at last the party ended. I bravely faced the must-do stuff: bags of trash to take out, chairs to stack, and a keg of beer to chug-a-lug.

No sooner had Year-One Celebration moved out to Memory Lane, did Year Two start with a bang. I had a UTI – urinary tract infection! It was my third UTI event since starting CO-1686 and my nth since time immemorial. This UTI is not related to cancer or CO-1686 but because I’ll refer to a previous post, I must share the story with those who give a damn.

UTI is common among women – a fact that hacks me off because I already paid my dues in society. I believe senior babes, especially those with lung cancer, should already be exempt from UTI, cold, and gas. But things have never been easy for me. It was just dumb luck that this recent UTI occurred days before my three-week blood-test schedule. It gave me ample opportunity to ask the Onc to include a urine test in the technician’s work order. Consequently, our visit included the urinalysis discussion.

“White blood cells are present in your urine,” announced the Onc, his voice dripping with concern.

“Uh-oh! We have an infection – a UTI,” I said nodding, enhancing my body language with an air of authority.

“Who is your primary care physician?”

“You are.” I flashed my modified Mona Lisa smile.

I love it when the Onc doesn’t argue with me. He said he will have the specimen cultured. “If the culture shows an infection,” he said, “I’ll phone in the antibiotic prescription to your pharmacist.”

I’ve seen urine culture reports. They show the cause of infection: virus, bacteria, or fungus. They show names of antibiotics that can eradicate the cause. They also provide names of antibiotics that are resistant to the culprit.

The culprit of the UTI under discussion now turned out to be e. coli – the same bacteria that hit national news when a bunch of Americans who had waddled from one end of salad bars to the other got deathly ill, resulting in the recall of a certain brand of organic spinach.

Some antibiotics have developed resistance. A big part of the blame, so I’ve read, is that as soon as some patients felt better after the second day of taking the antibiotic, they quit the week or so regimen. That would include me among those who made that adversarial contribution to the field of medicine. I’m hoping my selfless participation in the CO-1686 clinical trials will atone for our sins to mankind, you antibiotic regimen quitters you!

So my primary care physician by proclamation prescribed a seven-day regimen of a sulfa drug to fight the UTI. The last time I took sulfa drug was when I was a little girl living in squalor in Manila. It was the medicine of the day for any body part that ached – tooth, stomach, head. I figured this time, taking the pills one in the morning and one in the afternoon for seven days would be a breeze. Was I in for an unpleasant surprise! After the second day of ingesting the antibiotics, I felt like caca and it showed. It affected the other half of the population of the house. He missed the belly laugh. He suggested that I ask the doctor for a different antibiotic, but I told him it’s not in me to do that. I like to push myself and boasted that I was the recalcitrant kid who fought and beat seafood allergies. I said I could do seven days of feeling like caca. Easy.

I revisited Google University and audited courses on the modern-day sulfa antibiotic. I learned that this antibiotic’s modus operandi in fighting infection is by inhibiting the production of a certain body acid, which is too complicated to translate. One thing is clear: the human body is an awesome machine when in normal form. Remove a certain acid from it and a chemical imbalance happens to the human being.

I hung in there for the seven-day duration. Every day, I counted down…three more days…two..then one. The drug cleared up the infection but turned my system upside down. Eating became a challenge during the seven days and two days afterwards. My face dangled over the commode around meal times. My glucose numbers shot up. “Eat or perish!” my inner nutritionist admonished.

Medical marijuana to the rescue! My friend Goody Two Drops and I hadn’t said hello since December 23rd, 2014. It was time for a reunion. I retrieved Goody Two Drops from the refrigerator’s inner sanctum where it had sat with the anti-nausea cola syrup untouched for three months. I read the tincture dosing instructions again. The drops landed gently under my tongue. My head buzzed a little. In time my appetite roared back to life. Amazing stuff my buddy Goody Two Drops, which got me to thinking that horticulture, the science of cultivating a garden, orchard, or medicinal plants, might be a profitable hobby for me to pursue as my age careens towards one hundred.

At the end of the sulfa antibiotic seven-day regimen, I stopped taking all – I mean ALL medication – for three days. It was kind of a vacation, a wash-out for my body from the relentless assault of chemicals.

A week into Cycle 17 of my CO-1686, I noticed my blood glucose had mysteriously returned to normal. I had to stop Metformin. I guess the human body, like a computer, can be rebooted! I have no other explanation.

Bottom line:
(a) The UTI resolved.
(b) My blood glucose is normal again.
(c) 2000mg Metformin is out of my CO-1686 clinical trial regimen, unless high blood glucose returns as mysteriously as it had disappeared.
(d) The first blood tests of my CO-1686 Trial Year Two yielded satisfactory results.
(e) I feel great.
(f) Goody Two Drops is in hibernation again in the refrigerator for future reactivation if necessary.
(g) This Tarceva Diva alias Tiger X (as in Ex) Kitten, has been fortunate indeed. So far.