Weeks 210-213: pulsing afatinib

Written by Lars Haakon Soraas

Weeks 210-213 in the war on lung cancer have passed. We have been a bit poor at updating this blog lately, but here is a summary of the current status:

  • As mentioned in the previous update Dyanne is now trying pulsed afatinib to see if this can help against the 13 brain mets that were identified on the last brain MRI. She is taking 150-200 mg afatinib once a week (for those who take the pill every day, the normal daily dose is 30-40 mg). The treatment has been pretty ok and side effects have been a bit annoying, but not overly bad. Some nausea and stomach issues, and fatigue. But mostly gone a day or two after she has taken the treatment.
  • In the past week Dyanne did a new MRI of the brain and also a CT of the lungs to check the status of the disease and to see if the pulsed afatinib has worked or not. We probably will get the results this coming week.
  • We have not measured the tumor markers CEA and NSE so frequently in the recent weeks. However, we have measured twice in the past two weeks now and will check these results probably tomorrow.
  • We are looking into doing stereotactic (focused) radiation of the brain mets. The MRI scan will help determine whether that is something that can be done and if it makes sense to do it.
  • On top of the pulsed afatinib and potential radiation, we are also planning to do chemo more frequently than what we have done in the past. In the past 10 months or so, Dyanne has gotten chemo around every 2-3 months. The goal has been to try to avoid resistance building up. We suspect that the intervals have been too long, allowing the cancer to spread to the brain. Hence we will try to reduce the time between chemos to around 4-6 weeks, meaning Dyanne may get a new chemo infusion already this coming week. The CT scan will help determine this.
  • We are also looking into which chemo to choose. Besides the carboplatin and etoposide, which is what Dyanne has gotten so far, we have found evidence for using paclitaxel and also temozolomide. We will discuss with our oncologist and see where we land on this.
  • Dyanne has been in ok physical shape the last few weeks. However, it is clear that being told of 13 new brain mets is no fun. Emotionally these past few weeks have thus been challenging.

The sun is shining in Oslo now and we hope everyone is having a good weekend!

Karaoke with friends

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