Homeward Bound, Part Seven
So…we have finally met the point of the doctor’s visit, in terms of the plot line of “Homeward Bound.” I decided to not include a depiction of my father in the art yet, for a number of reasons. One of the key reasons was that he just wasn’t that important to the simple, two panel presentation. Also, he didn’t really say a whole lot in the meeting with the doctor, which I think is why he ultimately has been so confused about his condition.
He had stage 3B lung Cancer, which is Bad. Real Bad. Surgery was done on one lung, to remove the largest masses, and the other lung was the target of both chemotherapy and radiation. These are things that we are used to, and we pretty much all have a vocabulary for. Pretty much, my sister and I were expecting to hear that:
A. Masses had regrown in his lungs, and
B. There would be a need for an aggressive, even rougher stage of chemotherapy in order for him to continue to live at all.
We were resolved to bad news.
When the doctor told us that the most recent scan had shown the growth of a few truly tiny masses, this was not unexpected news. We’re talking about 4 to 7 mm growths here…tiny things. You don’t want any growths in the lungs, to be sure…but these are not at the crisis point. We both expected to hear that there would be another round of chemo, followed by scans, and so forth.
Instead, we got another story entirely.
Apparently, during the summer, the removed tumors were run through a complete gene sequencing, called a “mutation panel.” That sequencing allows you to know the specific type of tumorous cell, down to really specific genetic components. Apparently, he has an “ALK mutation”, which is responsive to certain families of orally administered medications. Seventy to eighty percent of patients respond to these drugs, which attack those cells specifically, and no others. It’s a long term solution.
There are a few hurdles with insurance, but this is a thing. A very workable thing.
See how my sister is lighting up with chaotic fire in the second panel? That’s because she was then. Her question was a good one. “Why hasn’t he been on these meds the last two and a half months, if we knew this?” It was a solid inquiry, which needs to be more directly dealt with in a later part of this storyline. In fact, it became a central consideration the rest of the trip, that all important question.
Needless to say, later gatherings had a whole lot to do with why this targeted therapy wasn’t undertaken earlier. We will get to that. The part that amazes me here is the science. We are going to take just a tiny moment for some science.
Chemotherapy attacks cells while they are dividing. It ruins them in fact, as they are dividing. Since cancer cells multiply faster than normal cells, and the tumor is smaller than a person, this pretty much kills the tumor before it kills you, and solves the problem while punishing the person. It also compromises your immune system, which relies on cell division.
This therapy that my dad is going to take…it specifically goes after the generic template of the tumor, or a highly specific type. Unlike chemo, the side effects are minimal…comparable to taking over the counter pain meds. If it works, he will need to take them to manage his condition for the rest of his life…although that lifespan could be much longer, and of higher quality, than with chemo and radiation.
Despite the confusion about why we weren’t doing it already…my sister and I put that chemical (crizotinib) firmly in the win column, and pretty much green lit the procedure.
The investigation, of course, came later.