Where's the AAA Triptik?

One of the things about having this disease, that doesn't have a proven roadmap, is that there seems to be a lot of potential routes to get to Curedville.  That's great.  The problem is that most of the routes that point to Curedville end up as dead ends (Is there a different term I could use, please?).  To be honest with you, if we can only find our way to Remissiontown, I would be pretty psyched.  In fact, I wish more people lived there.

We've been spending a lot of time over the last couple of weeks learning about the different routes available to us and trying to make a decision of which way to go.  Our medical oncologist (I'll introduce you to her later) is kind of like our navigator.  She has presented us with a couple of options and explained to us the possible roadblocks, detours and bumpy roads that may lay in our path.  By the way, she's been fantastic with us so far. 

The first leg of our journey will involve some pretty serious drugs and a couple of extended stays in the hospital.  After I'm finished with my radiation treatments (which are beginning to show some results in the form of less pain), I will immediately begin the immunotherapy interleukin-2 (IL-2).  I'll be in the hospital for 5 days receiving up to 14 infusions of IL-2 followed by a week at home and then back to the hospital for 5 more days and up to 14 more infusions.  This one could prove to be a bumpy leg of the journey with some pretty serious side effects including low blood pressure, irregular heart rhythms, accumulation of fluid in the lungs, fever, vivid dreams (sweet) and very rarely death (not so sweet).  The response rate to high-dose IL-2 ranges from 10% to 20% and approximately 4% to 6% of patients may obtain a durable complete remission and be long-term survivors.  In other words, there is a 20-60% chance of durable remission if I have any response rate, but there is only a 20% chance of that.  That should clear it up for you if you are Yogi Berra.  Seriously, it would be pretty sweet if this route took us directly to Remissiontown.

Turns out that there are some routes that are not available to us at all.  Some treatments require that I and/or my cancer have certain characteristics.  One of them is a very new drug that in order to be effective, my cancer needs to have the BRAF V600E genetic mutation (If you want to know what that is you'll have to look it up yourself since I'm not a doctor).  The drug is called Zelboraf and it has shown to be very effective at extending the lives of those with metastatic melanoma.  That is very exciting news except for the fact that I have tested negative.  Sorry folks, this road is closed.

Luckily, we do have another highway that is open to us.  This one involves a treatment called adaptive T-Cell therapy.  Basically, my own t-cells are harvested from my body, cultivated in the lab and supercharged (my term, not a scientific one) and then introduced back into my body.  At the same time, I would be given another drug called Ipilimumab (or ipi for those not so nimble of tongue).  This is another form of immunotherapy and has shown some very promising results also.  If necessary, we will be heading down this road after the IL-2 leg of the journey. 

I'm convinced that we will get through this.  Don't get me wrong, I know that things are going to suck for a while.  There are no shortcuts.  We'll make wrong turns, run out of gas and wish the road was smoother and shorter, but we will make it to our destination.