Dana Farber

Today I met with a doctor at Dana Farber to review my case and discuss medical trials that would be appropriate for my situation.

A lot happened, but I'll try to summarize.  We met with an awesome woman who sounded pretty encouraged about a number of opportunities.  One in particular has shown promise for women with the BRCA mutation, and I plan to participate in it.  This link describes the study:

http://clinicaltrialsfeeds.org/clinical-trials/show/NCT01009788

Here's the logic behind the trial:

The BRCA mutation contributes to a cell's inability to inhibit tumor growth, which is why BRCA mutation carriers are so much more likely to get cancer.  The study combines two drugs - a chemotherapy drug (Temozolomide) with a PARP inhibitor (ABT-888).  [PARP stands for poly (ADP-ribose) polymerase.]  The chemotherapy drug destroys a cell's DNA.  The PARP inhibitor prevents the cell from repairing the damage.  The idea is that the cell won't be able to repair the damage, and then it will die.  Since BRCA mutation carriers already have trouble repairing cell damage, this population seems much more likely to benefit from this treatment.  In fact, earlier on in the trial, BRCA mutation carriers and non-carriers were allowed to participate but only BRCA mutation carriers responded to the treatment.  Some did very well, and one patient experienced a complete disappearance of her tumor.

The study had room for one more participant, so I decided to sign the release and join the study.  I had a baseline CT scan today and I expect to start treatment on Monday.  While I wish it were sooner, it's not too far away and I'm pretty excited about it.

I'm sad to be leaving my existing oncologist, but I think this is a really good opportunity for me.

At this point, we still don't know much about my individual prognosis.  The idea is that we have to see how well I respond to treatments.  Hopefully the treatments will stop the growth of the tumor or even shrink it.  I will take a course of treatment until it stops working and then I move on to the next treatment.  This is what the rest of my life will be like, but my new oncologist sounded hopeful that it could last a long time. For this particular study, I'll take the chemotherapy drug and the PARP inhibitor orally for a week, and then I'll have three weeks off.  After two cycles of this, I'll get another CT scan to see if the tumor has responded.

While it's kind of scary to be veering off the standard course of treatment and seeing a new doctor, it feels to me that the standard course of treatment is probably not going to be sufficient.  A week ago I was devastated and now I'm thinking differently and I'm hopeful that this will make a difference.

Oh, and I decided that I'm going to do things a little differently this time.  I want to talk about something in addition to cancer and treatments.  For the past year or so I've been knitting (thanks to Jocelyn).  I'll put some of my projects here.  One thing I'm working on is my "waiting socks".  I started them today when I was in the waiting room at Dana Farber.  I waited an entire toe on two socks!  Actually, it was longer than that.  I waited two toes, then I made a mistake and restarted them both.  So it was pretty much four toes.  But, although I had to wait a long time, it was definitely worth it.  My new oncologist spent TONS of time with me and I'm really happy with her.  Anyway, here is my progress on the new socks...