Once I Was A Little Red Car | Mar 18 2022

March 18, 2022

My cancer center loves me. Phone calls, emails, texts: sometimes it feels like a deluge. There have been lots of missives this past week. I could go through them all, but that would lay me flat. The one that put me over the edge was not the 30 minute information call with the office of Mac the Knife (Dr. Gamma Knife) to talk about the procedure on the 28th, nor the call with Dr. Lungs who was a baffled as I about why I should check with him about stopping a blood thinner before the procedure, nor the seemingly endless emails about checking in for this or that.

No, what flattened me was yesterday’s call from the cancer center’s financial coordinator. The plan is for me to start Osimertinib, a third generation TKI (tyrosine kinase inhibitor) that has been a miracle drug for many lung cancer patients.

[We interrupt this blog post for a Public Education Announcement]

What Are Cancer Growth Factors and How Do They Work?

TKIs are one type of cancer growth blocker.

Growth factors are chemicals produced by the body that control cell growth. There are many different types of growth factors and they all work in different ways.

Some growth factors tell cells what type of cells they should become (how they should specialize). Some make cells grow and divide into new cells. Some tell cells to stop growing or to die.

Growth factors work by binding to receptors on the cell surface. This sends a signal to the inside of the cell, which sets off a chain of complicated chemical reactions.  (Cancer Research UK)

One type of growth factor is epidermal growth factor (EGF), which controls cell growth. Each growth factor works by attaching to the corresponding receptor on the cell surface. For example, EGF binds to epidermal growth factor receptor (EGFR). I have mutations in the epidermal growth factor receptors in my lung(s). These exist in exons, certain portions of a gene. My mutations are in exons 20 and 21. Thus, I have EGR mutations L858R in exon 21 and S768i in Exon 20

Tyrosine Kinases are chemical messengers (enzymes) used by cells to control how they grow and divide. They act like an ‘on-off’ switch. When the growth factor attaches to the outside of the cell it switches the tyrosine kinase ‘on’. This signals the cell to divide.

Cell division overload = cancer.

What Are Cancer Growth Blockers and How Do They Work?

A cancer growth blocker is a targeted drug that blocks the growth factors that trigger cancer cells to divide and grow.

Most of these treatments work by blocking the signalling processes that cancer cells use to divide.

Cancer cells are often very sensitive to growth factors. So if we can block them, we can stop some types of cancer from growing and dividing. Scientists are developing different inhibitors for the different types of growth factors.

(Cancer Research UK)

TKIs are one class of these inhibitors. There are others (and I am happy to announce there is something called a Hedgehog Pathway Blocker. This does not involve hedgehogs, obviously, unless they are teeny tiny and swimming in our cells).

Osimertinib is a TKI. There a bunch of others but we only care about Osimertinib today.

(Although we cared about Afatanib last week, but then we didn’t.) (Oh. I guess I didn’t tell you about that part. Well, it was a Thing last week. It involved lots of reading, a discussion with the oncology pharmacist, a call with one of My Heroes, Dann Wonser, from my local lung cancer group, posts to my lung cancer groups online, and a productive email with Dr. Oncology. Now it’s not a Thing, but it might be in the future.) (But I hope it won’t because the side effects are horrendous.) (All of this hoo-ha is why I am just worn out sometimes.)

The Call that Flattened Me on March 17

Ms. Financial Coordinator wanted to tell me what Osimetinib would cost. Please sit down.

This is my co-pay.

Ms. Financial Coordinator has already got a team working to get the drug for free or at reduced cost from the pharma company.

Now, please excuse me. I have to go lie down.

Before I do, here is a cake I delivered this past week, for a kid turning 15. He wanted an Oreo cake. This is an Oreo cake, Oreo filling, Oreos. 

The best part: eating the mistakes.

Hmm. If I had some mini Oreos I’d eat them now, then lie down.

Thanks for reading. Here’s hoping all your copays are small and mini-Oreos roll across your path.

Car image by Mabel Yeap from Pixabay