Shadrach, Meshach, and Abednego

This will be a quick and informational post, with details and impressions to follow:

We met the medical oncologist today, Dr. L, and I’m happy to report she struck us as sharp, personable and committed. She was patient with our questions and, like us, interested in pursuing aggressive treatment. (She was also very accommodating of our large note-taking entourage.)

She told us the MRI was fine: as we’ve always known, Val’s brain is in excellent condition.

She reaffirmed what others had told us: that Val’s lung cancer is stage four; that (because of the main tumor’s location and intertwanglement with important vessels) it’s inoperable; that chemotherapy should begin as soon as possible. She specified that in addition to the main tumor in the right lung, one other smaller nodule (1 cm) can be seen in her right lung and two in her left. This arrangement sounded very tidy and contained to us, so we consider it (within the parameters of the situation) good news.

Chemotherapy and radiation are both treatment options available to us. If the main tumor’s position near Val’s airway causes her serious breathing trouble, then targeted radiation could reduce its size; but that’s not currently a problem. The most aggressive course now is to do chemo, so that’s what we’ve signed on for. They will treat her with a combination of Paclitaxel, Carboplatin, and Bevacizumab. Which sound to me a little like some of Beelzebub’s henchmen (henchdemons?). But wait, no, maybe they are cousins of Shadrach, Meshach, and Abednego, and will see her safely through the fire. That’s a better line of metaphor.

Through a stroke of luck Val is also eligible to participate in a clinical trial of the drug Apomab. This is a randomized, double-blind, phase II trial of the other three drugs plus Apomab, “in patients with previously untreated, advanced stage non-small-cell lung cancer.” Her luckiness is underscored by the fact that the roster for this international trial is almost full, so we are just squeaking in at almost the last possible second. The doctor and clinical trial nurse seemed to consider it a lucky break, apologized that we’d have to decide by Monday (!), and encouraged us to participate.

The wince factor comes with the fact that in a double-blind trial of this sort, half the participants receive the drug and the other half get the placebo. This would be an excellent focal point for all those on prayer chains, in my opinion. We want that drug. Val opted to sign up for it.

Chemo should start next week, possibly as early as Wednesday. She’ll go in for new infusions every three weeks, with CT scans every two cycles (every 6 weeks). We are excited at how fast they are moving for us.

It’s late and I’m going to have to switch gears for work at the library tomorrow, opening this year’s grand Summer Reading Program. Hard to imagine. A friend is flying in from New York tomorrow for a week, and my sister comes next weekend. We plan to spend the next few days partying like it’s 1999: hiking, picnics, playing with dog.

It’s been gray, cloudy and cold in Portland for weeks. Tomato vines don’t grow. Mornings call for mittens. I wore my down coat and fleece hat to the hospital today. But when we emerged from the oncology building, for the first time in weeks (in a perfectly heavy-handed but mood-lightening coincidental metaphor)… the sun was shining.

So we went out for fish tacos.

Deborah