It’s been about six months since my last update in June. The tl;dr is that I still have cancer and that my oncologist has just switched me to a new drug regimen that should take less of a toll on my body overall and potentially be more effective at combatting the particular type of cancer that I have. We will be doing this new treatment for three months before imaging again to determine its effectiveness. So I will likely post a next update at some point in late January/early February.
The good news: The cancer has not spread from my liver and my liver continues to function normally as do all of my other organs. I have no pain or really any symptoms of the cancer itself — just the chemotherapy that I have been on, in various iterations, since April 2021. The cancer also seems to be slow growing: The areas we have been monitoring have stopped shrinking but shifted up and down in size incrementally over the past nine months or so (we’re talking in fractions of centimeters with the largest area being about 3cm in diameter). So we have time to explore different combinations of drugs and other treatment options.
In September, Hanna and I met with an oncologist at the Dana Farber research center here in Boston, a close colleague of my regular oncologist, who is involved in clinical trials. This review of my case was to determine whether there are any clinical trials for which I am currently eligible. Unfortunately, my cancer cells are “weird” (the highly technical term they keep using) in terms of their specific mutations, so I was not a match for any current trials. However, they now have my genetic profile in their system and are in close consultation with my oncologist should any trials open that look promising.
In the meantime, we made the decision this week to switch from the chemotherapy I have been on, which has become less effective in combatting cell growth, to a treatment called immunotherapy. Immunotherapy “takes the breaks off the immune system,” encouraging your body’s own immune defenses to attack the cancer cells which normally disguise themselves as cells the immune system can ignore. This therapy has been used successfully colorectal cancer that has certain genetic deformities, something called “mismatch repair-deficient” or “microsatellite instability.” In the latest genetic testing they did for me, I came back with high microsatellite instability. This makes me a good match for the treatment. A write-up of a recent clinical trial involving patients with rectal cancer can be read here. All of the patients in the study have since been cancer-free for two years post treatment.
The other benefit of this treatment is that it has fewer adverse side effects, meaning that I should start to feel better on a daily basis and have less of a roller coaster in terms of symptom management than I do with the fourteen-day chemotherapy cycles. In addition to fewer side effects, the immunotherapy infusions are shorter and done entirely at the hospital, meaning that I don’t need to go through the rigamarole of bringing an infusion pack home for 46 hours and going back to be “de-accessed.” And the cycle is 21 rather than 14 days, giving me alonger period to recover between infusions.
While it’s always a bit scary to change up treatment plans — especially when the reaso is that the old path is no longer effective — I am feeling hopeful about this new course and looking forward to simply having more energy and fewer uncomfortable symptoms as we take a break from chemotherapy. I had my first infusion was this morning and I am feeling pretty normal rather than wiped out with a handful of annoying side-effect symptoms to manage.
Fingers crossed for an easy end to 2022 and some good news early in 2023.