Ready, Set ...

STOP!!!

The drug trial I was to take part in has been cancelled. Turns out one of the drugs (Foretinib) is causing blood clots in the lungs of some folks who have been taking it. It should be said, however, that the woman who had already embarked on the drug trail I was take part in has not experienced any such problem, nor has she had any other particularly unsavoury or unexpected side effects of the drug cocktail (Fretinib + Lapatinib). Even so, the makers of Foretinib have pulled it from general use as well as from any ongoing or upcoming drug trials as a precaution until they are able to remedy the situation.

Confess the news threw me for quite the loop. I was so psyched up for the trial, eager to try something that might be the answer to my problems, at least for the foreseeable future. Alas, it was not to be. Although I have never borne children, I suspect the feeling currently experienced would be akin to thinking I was entering my third trimester only to learn that I was never pregnant but was suffering from the lasting effect of a rather satisfying albeit indulgent ingestion of some sort. My brain is having a trouble shifting gears.

Some potential alternatives:

I could take the Lapatinib alone. It is fully licensed (unlike Foretinib) and has a much longer history of use. However, Lapatinib is not covered by either government or private health care programs. I would have to pay the entire cost of the drug myself - to the tune of $3500/month!! Okay, so the drug company is willing to offer a discount to non-extended-health-coverage patients, but that amounts to little more than a $500 reduction in the cost. Even at that, the price far exceeds my budget. Thus, this is not an option.

Another suggestion is to take another drug entirely. Capecitabine is another drug that has shown good results in patients with a similar case history to my own. This is another orally-administered chemotherapeutic agent. One cycle includes two weeks of treatment (one pill twice/day) followed by one week without treatment. Cycles can be repeated every three weeks. The advantage of this option is that it can be undertaken in Sechelt, under the supervision of Dr. Wadge. In addition to the usual nausea, diarrhea and fatigue, Capecitabine can cause mild to severe renal dysfunction as well as myocardio infraction or angina, as well as something called hand-foot syndrome. Given the hand and foot issues I experienced while taking Taxol two years ago (with mild tingling continuing to occur in my left foot and ongoing cramping of finger joints in both hands these many months later), I'm more than a tad leary of this alternative.

Of course, there is nothing that says I have to accept either - or any - of these courses of treatment. I currently feel very well. I have a decent level of energy and mobility. I have no pain, only mild discomfort and then only occasionally. The cancer is not spreading so quickly that I must decide a plan of action immediately.

So I'm opting to do nothing. For now. I'll take the time to make every effort to cross a few more things off my "bucket list".

Should I change my mind in a day, a week, a month, a couple of months, my oncologist will be more than willing to talk to me about the various options (as listed above as well as some other IV-administered drug options) when I feel symptoms worsening or should I feel the need to start on another treatment for whatever reason. Remember, the goal is quality of life. My reality is that the disease will spread to other organs over time no matter what my oncology team throws at me. Nothing will ever be a "cure". My life will not be prolonged. But if what I'm currently experiencing is any indication of how things will go for the foreseeable future, I see no reason to try a new drug that might not sit with me as well as past treatments have. I count myself incredibly luck to have experienced so few side effects. I'm not keen to push my luck any more than necessary.

For now, I'm taking a short course in glass fusion and planning to host Christmas dinner in my beautifully renovated home. Yup, things could be a lot worse.