If it seems like it has been a long time since we've blogged about Melinda's cancer battle - it has! After 2 PET scans that showed impressive improvement in decreasing both the size and numbers of tumors of her small-cell lung cancer, her oncologist gave her the month of November off treatment to recover, and restarted another set of cycles in December. Just today we got official word from the latest PET scan (taken every 2 cycles - about 2 month intervals) from a week ago.
And the word isn't good... Increased metabolic activity, and more tumors are visible. Dr. Garland is quick to point out these spots aren't "new", even though they haven't been visible the last couple scans. Going back to the Summer, these are old spots that are coming back. This is now the second time we've seen this - a drug that initially worked well slowly becomes ineffective as the cancer develops an immunity. While some might wonder what would have happened if we hadn't taken the month off, you can't ask that question - water under the bridge. At the time we didn't argue with the decision, though I do recall asking the question. All we can do is trust the doctor's recommendations and we will continue to do that.
So since the Irinotecan is no longer effective, we were concerned the doc might be running short of drugs to try - but not to worry! She always seems to have something to give us - in this case she wanted a drug that worked substantially differently from what was just abandoned, and chose Navelbine - a drug normally used for non-small cell cancer. We've already given the drug a pet name - "navy-bean". It works by inhibiting cell division, which is what causes cancer cells to grow unchecked. We're currently awaiting her insurance to approve treatment (Melinda has changed insurance 4 times since September, and she just today started Medicare - now THAT is an epic story!). We expect that to get approved and she'll receive chemo on Thursday, and go in for the normal weekly infusions for 3 weeks, then a week off for her normal cycle. Two more cycles and another PET scan - so we'll know if it is working come the first week of April.
The other complication is that the most recent PET scan showed a speck in her brain, while the brain MRI taken 4 weeks ago to look for such things didn't show it... So they are repeating the brain scan also on Thursday. If confirmed, they'll likely do radiation to zap it, but will learn those plans once we get to that point... Stay tuned - the battle continues!