We Interrupt This Lung Cancer… | Feb 26 2022

Saturday, February 26

…for frosting! My first bake for forgoodnesscakes.org; my first delivery to a youth agency about 45 minutes south of here. And here you thought frosting school was just for fun. This demands hard work! Practice! Frosting spattered all over the kitchen!

Frosting school this past week also saw us free-styling ducks, hearts, a dinosaur, although I’m told this is more of an alligator:

The next two days will be a strenuous effort in flower-making. That’s because Tuesday is slated to be a Big Day: frosting and (tastefully) decorating– with those hand-crafted flowers– an entire cake. We received instruction in the Importance of Coordinating Colors if we were making flowers for the class. It’s only cake I found myself muttering. But will you find me on the Adobe Kuler site for designing color palettes? Oh, you betcha.

Tuesday is also a brain MRI.

I’ll get home from frosting school, have lunch, take my anti-freak-out medicine, and get chauffeured to the cancer center, where, by the time I sign in, I should be Feeling No Pain. We’re looking to see if that itsy-bitsy brain lesion from last time has grown or disappeared. You know which one we’re rooting for.

Monday is easier– it’s just a PET scan. The preparation for that is more involved. Nothing to eat or drink that morning. Low-carb dinner the night before. No vigorous activity the day before. All of this is to starve my body of sugar so that it will slurp up and circulate the sugary injection of tracer material. Those hyperactive cancer cells suck that up like greedy little hoarders. Then they glow bright green on the scan. We hope all the organs stay a boring black.

Yesterday, Friday, was the pulmonary function test. You sit in a little room and blow into tubes until you see stars. This is supposed to indicate how your pulmonary system functions: lung volume and other stuff I don’t care about because I’m riding my bike like a madwoman and that tells more than any tube-blowing. Then I walked up and down a hall for 6 minutes with a little machine dangling from my forefinger– one of those pulse oximeters. The oxygen level in my blood was between 96-98%. My pulmonary is functioning just fine, I told Mark.

Otherwise, I’m a wreck. There’s a thing called scanxiety, which is not anxiety about the tests themselves, but about the results. We see Dr. Oncology first thing Wednesday morning.

I’ve been researching approaches to treatment targeted on interrupting the actions of EFGR L858R and S786i, the EGFR mutations that drive my cancer. There’s good news and bad news in the mutation department. The good news: L858R, a point mutation on Exon 21, is common enough to that most of the (paltry) lung cancer research has been focused there. S768i, a point mutation on Exon 20? Not so good. Fewer than 1% of lung cancerites have it, so for that, the medical folks rely on the age-old practice of A Wing And A Prayer.

Lung cancer researchers are currently on the third generation of TKIs (tyrosine kinase inhibitors) that interrupt the stealthy work of a multitude of mutations. S768i lives in fear of a second-generation TKI, which L858R doesn’t like at all. L858R, however, dies with a third-generation miracle TKI, just recently approved. S768i doesn’t like this either. The dilemma in my mind, shared by others on a variety of lung cancer discussion boards is this: If you’ve blown your wad on the generation 3 TKI, can you go back to the second generation if generation 3 doesn’t work? Or makes you so sick you just wish you were dead? (Can you see the Ghost of Pneumonitis Past looming in the corner?)

The brain thing is no biggie– if it’s a metastases, they just gamma knife it. (I’m sure I’m not the only one that thinks the docs on the gamma knife page look like a bunch of 12 year-olds.)

So don’t mind me if I snarl or burst into tears if you so much as look at me cross-eyed. I also have to clean the bathroom, so tensions are high.

In the meantime, thank you for reading. I hope your day includes cupcakes, teeny frosted things, and few, if any, anxieties.