Wednesday, March 11, 2009

What's Up With the Doc 45? - It's My Anniversary!

Yep, a year ago today the final pathology report came back telling me that I had stage IV lung cancer. While I haven’t quite reached the published mean survival for my initial chemotherapy regimen (that will be in another couple of weeks) I’m pretty confident that I’ll still be around for that. I had my first cycle of Cisplatin/Taxotere last Friday and am slowly returning to the world of the nonmiserable.

This has been a week of reflection and recentering for me. While my first chemotherapy regimen produced about a 40% reduction in the tumor in my liver, every scan since we stopped that chemo (that scan revealed stable disease with no further reduction in tumor size) has shown progression. Basically, since last September I’ve been on treatments that have made me feel varying shades of awful and provided no real benefit in the way of disease control. I know that this is not how I want to spend the last months of my life. So I told the oncologist to take his very best shot with this chemotherapy regimen because this is it for me. I will do two cycles and scan - if the scan shows stable disease or better I’ll negotiate with him about how many we’ll do total, if the scan shows progression I’m done with traditional chemotherapy.

I have an appointment at Dana-Farber to talk about some promising trials currently ongoing or about to start utilizing receptor inhibitors that will be dependent on molecular testing of my tumor. There is not enough tissue from my original biopsy for this additional testing so I am going to have to have a tissue biopsy before that appointment.

This all makes sense to me - one last shot with traditional chemo, followed by a clinical trial if there is one that makes sense for my tumor’s molecular biology. If neither gives me a significant or sustained improvement I will be ready to opt for best supportive care so that I can feel as good as I can feel for as long as possible. I’m sick and tired as a result of chemo. Sick and tired would be fine if the chemo were benefitting me, but it hasn’t been so I’m ready to opt out of sick and tired.

Which is not to say that I’m giving up. I don’t call sitting in the chair for the cis/taxotere giving up. I don’t call undergoing another tissue biopsy to get molecular markers giving up. I call it setting limits. I call it maintaining as much control over the quality of my life as I can manage. Meanwhile - still here, still working, still loving life, definitely not dead yet!


Nick said...

A beautiful expression of what it means to be a human being.

Catharine said...

Lisa -

Congratulations on this anniversary!

I continue to admire your approach to this disease and your willingness to battle on with intelligence. (I'd prefer to call NSCLC by a much nastier name, but that wouldn't fly in polite company.)

Here's hoping that something great occurs with your Dana-Farber appointment.

Cal said...

Sunny, I am so sorry this is happening to you. Your attitude towards this is such an inspiration. Congratulations on the anniversary.