Weeks 206 & 207: Pain. No gain.

Written by Lars Haakon Soraas

Weeks 206 and 207 in our war on lung cancer have passed. We are disappointed. Here is an update:

  • As described in our previous post, we have over the summer gone all in on immunotherapy and tried several different immunotherapies. We had hoped that they, alone or in combination, would help control the cancer.
  • In addition to the attempts described in our previous post, in early August we also tried a few days of fever induced by Coley’s toxin. We carefully escalated the dose and on the third day reached a dose (only 0.0001 ml!) that induced a fever of around 39.2 C. We continued for another 2 days and also then reached in that range. Needless to say, this treatment is rather taxing on Dyanne. But we had hoped it could help boost her immune system and, through this, help combat the cancer.
  • So, have our attempts at immunotherapy paid off? Unfortunately, it does not seem so. Or, if we want to be optimistic: at least not yet…
  • As readers of this blog will know, we track two tumor markers in blood (CEA and NSE). These usually give a good indication of whether the cancer is growing or shrinking. In the past weeks both markers have risen sharply. Charts depicting this are pasted in at the end of the blog post.
  • Further evidence indicating there is progression comes from a CT scan Dyanne did last week. The lungs seem relatively ok, even if they are a bit difficult to interpret due to the cryoablation she got there. In the liver, however, there seems to be progression. When it comes to the bones, the scan says that the the situation is pretty stable. However, in the past two days Dyanne has had an increasing back pain and feeling “pins and needles” in parts of the right hand. We thus believe there also is progression in the bones.
  • On Sunday a week ago, Dyanne also experienced shortness of breath. We went to the hospital, where they did some blood tests and an X-ray. They could not find any obvious cause of the shortness of breath and thus sent us back home. The next day, Monday last week, the coughing seemed worse and we went back again. They then did a CT scan and, again, could not find any obvious cause for the shortness of breath. Maybe it is the cancer, maybe pneumonitis, maybe a small infection, or maybe some local reactions following the cryotherapy. Luckily, the coughing got a bit better in the following days. And the shortness of breath has not gotten any worse, maybe even a bit better. Hopefully time will fix this problem.

We are obviously disappointed with the results. We have put in a lot of effort, resources and not insignificant amounts of travel, toxicity and risk over the summer in order to implement an immunotherapy approach that we really had hoped would kick the cancer down the road for a long long time. What have we got to show for it? The most fair assessment appears to be: nothing.

What next? The immediate plan is to do another round of chemotherapy. This will start tomorrow. We also hope to have radiated the metastasis in the spine that causes the back pain. Hopefully this can take place next week. What then? We don’t know yet. Back to the drawing board.

CEA, red markers indicate when chemo was given
NSE, red markers indicate when chemo was given

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