This is a cancer update.  Yesterday I had my last of 4 expected chemo infusions, and my first of many immunotherapy infusions.  I mentioned before that I take an anti-side effect medication for the first weekend, but I’ll be fatigued for some of next week.  There may also be some additional side effects from the immunotherapy, Keytruda.

I’ve been very cautious about getting sick up until now, since I didn’t want to have to postpone treatments.  But after next week, I’ll probably start being more free to “move about the cabin” as it were.

This last round has not been without drama.  On the Sunday right after my last infusion, I passed out twice within a few minutes of each other.  I was probably only out for a few seconds both times.  I ended up going to the ER but my visit there was actually pretty uneventful.  They couldn’t really find anything, and said it was pretty much just the chemo.  So Kathy took me home after a few hours, and I’ll just need to remember to get low right away if I get lightheaded again. We’re always thankful when they don’t admit me!

My chemo side effects have been quite mild, which I’ve been very happy about.  I threw up a lot after the first infusion, but not the others, which is great.  I have another kind of amusing side effect of chemo that I’ve never been aware of.  My skin is shedding a lot, kind of like full body dandruff!  Kathy jokes that it’s like having her own personal snow globe!  Every time I change my clothes, there’s a flurry of “snow” as I fold them!  Kathy even says that I look younger with reduced age spots!  And no, I don’t recommend this method of exfoliation! Anyone else have this side effect?

After a low weight of 165 lbs, I’m back up to 180, which is great.  I’m going to take a little pause from the weight gain until I can start meeting with my physical therapist on the 16^th.  My target weight is 190 to 195, and I want to put on some muscle instead of fat!  So I’m cutting back from 2 bowls of ice cream a day to just one!!  Favorites are Mint Chip, Mocha, and Cherry from Tillamook.  This is just an interesting detail.  Please don’t leave a bunch of ice cream on my porch!

A little detail about my daily life is that we love Gospel music and I’ve have fallen into the habit of waking up to “You are the Living Word” and “Give Me a Clean Heart” by Fred Hammond. They’re great songs, with great bass lines, of course.  I try and get out of bed before the first one is over!

Back to the medical side, my prognosis remains good and my tumors are shrinking faster than anticipated.  I’ll get a PET-scan on the 30^th.  For this test, I have radioactive sugar injected, then wait 45 minutes for the cancer cells to suck it up.  Cancer cells love sugar, and quickly absorb the radiolabeled glucose.  Then I get scanned in a specialized scanner and see how the tumors look.  PET scans are the most sensitive way to detect tumors and allow doctors to see even small tumors wherever they are.  My chemo oncologist expects that my rib tumor will already be completely gone, and that my primary lung tumor will be much reduced.  The chemo will continue working for awhile, and the immunotherapy will continue for to up to 2 years!

A word on immunotherapy.  As mentioned in Update 7, immunotherapy agents cause T and B cells to attack tumor cells.  Some tumor cells express a surface protein called PD-L1.  This protein causes the immune system to see the tumor as “self” by binding to the PD-1 protein on T and B cells.  Keytruda stops these proteins from binding to each other, causing the T and B cells to see the tumor as alien.  Unfortunately, this can cause some normal cells to appear alien as well, leading to some side effects.  My autoimmune disease is not expected to be impacted by all this, but I’ll need to be monitored to make sure.  My oncologist says that since my tumors have a lot of PD-L1, this therapy may work especially well on my tumors.  Depending on how I respond, I may end up being on Keytruda for up to 2 years!!

Please continue to pray that my tumors will become normal lung tissue and not scar tissue.  I’ve also had some shortness of breath for the last 2 weeks, but I’ve seen some improvement over the last few days.  Pray that my lung capacity improves!

Merry Christmas and Happy Hanukkah,
Erik

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