Thank God

I am so excited!
When the clinical trial medication I was on stopped working, a biopsy was done and the preliminary results showed that I was not a candidate for any clinical trials or targeted therapy. I was therefore scheduled for traditional chemo, which I was to start today.
I went in to start my chemo regiment today and found out that my final biopsy results showed a new mutation of a gene called MET.
This means I may qualify for a new clinical trial of a targeted therapy combo of two new drugs, AZD9291 and AZD6094.
So no chemo today, but I should start the clinical trial within two weeks.
This is great because targeted therapy drugs that block the growth and spread of cancer by interfering with specific molecules ("molecular targets") that are involved in the growth, progression, and spread of cancer and are thought to be more efficient than traditional chemo.
I owe you thanks for all your prayers, there is no question that your efforts changed the course of my treatment.

Prayers needed

I am starting the new chemo cocktail tomorrow.
Carboplatin, Pemetrexed and Bevacizumab.
Please pray that it works.

A brief lesson and update

Some people have asked that I explain the basic types of treatment for stage four lung cancer.
I was diagnosed with stage four non-small cell adencarcinoma that has spread throughout my body.
There are three basic types of chemotherapeutic treatment for cancers that have spread widely throughout the body, before any treatments start.
1- targeted therapy
2- immunotherapy
3- standard chemo.

I started off with standard treatment and that worked for a short while. There are dozens of combos of standard chemo and that will always be available to me.

Targeted therapy is used when the tumor is tested for common gene mutations (such as in the EGFR, ALK, or ROS1 genes). If one of these genes is mutated in your cancer cells, treatment will likely be a targeted therapy drug:

* For tumors that have the ALK gene change, crizotinib (Xalkori) is often the first treatment.
* For people whose cancers have certain changes in the EGFR gene, the anti-EGFR drugs erlotinib (Tarceva), gefitinib (Iressa), or afatinib (Gilotrif) may be used as the first treatment.
* For people whose cancers have changes in the ROS1 gene, an ALK inhibitor such as crizotinib might be used.

My tumor was positive for the EGFR gene and I was on a clinical trial of super high doses Tarceva starting April 2016 for 13 months until it stopped working. While it worked Tarceva shrunk and eliminated most of my tumors.
By stopping to work, I mean that they found a bunch of new tumors, primarily along my spine.

They redid the tests again to try find any new mutation that will respond to a different targeted therapy drug and the initial results showed no new gene change. So unless further tests show a gene mutation, targeted therapy is off the table for now.


My tumor cells might were  also be tested for the PD-L1 protein. Tumors with higher levels of PD-L1 are more likely to respond to certain immunotherapy drugs, so treatment with pembrolizumab (Keytruda) might have be an option. People with the EGFR mutation that I have usually do not respond to immunotherapy. Ironically, immunotherapy works best on heavy smokers. I will be a candidate for immunotherapy if all other treatment options fail.

At this point I will return to standard chemo, as long as it keeps working or my tests indicate a better treatment plan.

The chemo along with all of your prayers and good wishes will let me continue enjoying life to it's fullest.

Thanks to all of you for everything.

update

I have not posted for a while because things were going well.
I feel great and except for the annoying side effects of the Tarceva (chemo) I was able to function.
When I started the clinical trial of Tarceva, (thirteen months ago) they explained to me that it often works for about one year at which point the cancer may get 'smart' and mutate and a new drug will be needed to fight the cancer.
On Tuesday I had my regular brain MRI and torso CT scan.
Yesterday I got the results and it seems that the Tarceva is no longer working.  Thank God there is no new growth on the brain. However, they found small tumors along my spine and other bone areas.
I will go for a spine MRI tomorrow for further examination and will be scheduled for a new biopsy. They will look to see if there are new genetic markers that will respond to a targeted therapy.
They will then change my regiment accordingly.
This may seem like bad news, but the fact is that there are great advancements in lung cancer and there are many medical paths to have a life full of quality.
I feel blessed to have so many family and friends praying for my good health.
I will keep you posted on new test results and treatment.

Continued good health

I had a CT scan and brain MRI yesterday.
The results are very good. Nothing has grown since the last set of scans.
Tarveca is really keeping the metastatic cancer from spreading any further.
I feel great and I am able to enjoy doing things that I planned on doing during my retirement, like spending time with family and traveling.
Thanks again everyone for your prayers and good wishes.

Thanks.

Wow! I can't believe that it's almost a year since my diagnosis and I feel great.
I've learned a lot this past year, but the most important thing I learned is that I can rely on my family and friends to be there for me.
I would not be doing so well were it not for all your help, advice, prayers and good thoughts.
Please keep it up.
Wishing you all a wonderful Chanukah, Christmas, Kwanza, belated Diwali, and Festivus.
My apologies to anyone I left out.

Update

I just got my most recent CT scan results.
Since I started with treatment my tumors gave shrunk by more than  half.
That translates to a 97% success rate.
I am thrilled with the results and the doctor has reduced my Tarceva pulse dose to 750 mg to lessen the side effects. This will hopefully increase my quality of life without compromising the treatment.

This is the first Thanksgiving in many years that I have not been able to go watch the Macy's parade, but I hope to go back again next year, God willing.

Keep up with the prayers and good wishes. They are working.

Happy Thankdgiving to all!