Wednesday, April 16, 2008


And the news wasn't good. 

Although the tumors hadn't spread, and there was no sign of anything on my lungs or other organs, they continued growing through the two cycles of Gem/Tax. So it's on to a new drug, temodar (temozolomide)

This is an oral agent, commonly used for brain tumors and as a radiosensitizer. Temodar's record with soft-tissue sarcoma is mixed, to say the least. The idea is that this drug's relatively long cycle (six weeks of daily doses; two weeks off) will align well with my still relatively slow-growing epithelioid sarcoma. If Temodar stabilizes the disease, I will then hopefully enroll in Ariad's trial of deforolimus, which is seen as a promising alternative to "watching and waiting."

L. and I both left marveling at Dr. S's slickness. She delivered some pretty lousy news, and she did so smoothly. The strategy was something like this: 1) get the bad out there quickly; 2) emphasize the normal or positive findings; 3) immediately lay out the revised plan, emphasizing the deforolimus carrot; 4) slip in some bad news about temodar's side effects; 5) listen to my lungs and leave.

I'll start temodar later this week, if the preapprovals go well. (They should: I was previously pre-approved for the drug, so we're not starting from scratch.) The common side-effects are nausea, constipation and fatigue, so Dr. S launches new temodar patients with Zofran, one of the heavier-duty anti-nausea drugs. Hey! I've been telling everyone that this would be easy and you write a script for serious anti-emetics! Damn you, Dr. S! Foiled again by that wily physician....


The title of this post is honor of my younger brother, C, who used to draw out "God... Damn... It..." into a kind of mantra, angry but also rueful, dispositive but also somehow searching. I took the soul out of it by reducing it to a compact G.D.I so I could allude to the idea but not pollute the mouths of my kids any more than I already have. 

Anyway, that was pretty much my reaction to the results: God. Damn. It. 

1 comment:

L said...

This is uncharitable, surely wrong, but could there have been just a tinge of smugness re the fact that she always said the tumors would be sensitized to gem/tax, despite what the elite medical oncologist in the cosmopolitan state had to say?