Changes Coming This #LCAM

Lisa Moran with Dr. David Carbone
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 November is Lung Cancer Awareness Month.

We have been monitoring lung cancer progression in my lungs for several months.

When I switched my treatment from the Dayton oncologist to Ohio State in August, 2022, my OSU oncologist seemed surprised that I wasn't having breathing issues after seeing the latest scan results. 

At that time, I hadn't noticed a difference. Since then, things have changed. I don't have a wheeze. It's a faint intermittent whine or squeal. I have been losing my breath easier. I'm OK sitting still. But with any walking, exertion, light lifting or even talking I have shortness of breath.

My oncologist and I discussed the latest biopsy and possible next steps in treatment. He was very upfront and frank. I appreciate this in a doctor. I just want the facts, no matter how much I don't want to face the reality. 

The information from the biopsy was good news to hear. We know the cancer is still non-small cell adenocarcinoma. It has not mutated to small cell, a more aggressive form of lung cancer.

 He reviewed the possible next steps for my treatment. Bottom line is, I'm running desperately low on treatment options.

I have to wait another week for complete results from the biopsy.  If a new targetable mutation is found, we will add a targeted therapy to my treatment plan. If not, my PDL-1 (a protien) level is high enough now to get positive results from immunotherapy.

I will likely start pembrolizumab. The brand name is Keytruda. I will have to quit my current targeted therapy, Tagrisso. The two treatments do great alone,  but don't jive well together.

Immunotherapy is an infusion once every 3 weeks. It does have minimal, tolerable and treatable side effects. I will need to decide if I will get a chest port. It makes infusions easier. The last time I did iv infusion treatment,  my veins became very problematic. I got a port. That was great for 14 months. Then the port got infected. Something I'd rather not experience again.

When I was diagnosed in 2015, immunotherapy for EGFR patients like me wasn't even an option. Now it's my best possibility.

There is a clinical trial for a different immunotherapy for EGFR+ lung cancer. Because of my damaged kidneys, I don't qualify for that trial. Although,  my kidneys and creatinine have improved and are the best they have been in two years, it's not

 enough for a clinical trial.

As an outlier and long term stage 4 lung cancer survivor, I've been aware, for years, of the lack of FDA approved treatments after progression on Tagrisso. I've been somewhat mentally preparing for this moment. The truth is, facing my reality and morbility is quite sobering.

 But hey! I'm still in the game. Instead of having three or four treatment options, I have two. I may be running out of treatment options but I will never run out of HOPE.