Cancer-Biology 101

[fictional]

Yesterday, we went to the doctor for the results of the latest PET/CT scan. And the news was what the doctor called "mixed" and I call "sucktastic".

Doctor: (examines my dad much closer than usual) So, do you have any new pain? Any coughing? Any anything?
Kali's Dad: No...?
Doctor: No? Really? ...Really? Hmm. Are you sure?

(Kali & Kali's dad exchange glances, which basically indicate, oh god, this can't be good.)

Doctor: Well. Hmm. The news is... mixed.
Kali's dad: Hit me.
Doctor: So. Basically the tumor is smaller. A little. Well, the one in the lung's upper lobe anyway.
Kali's dad: ...
Doctor: Which means the chemo's killing it. A little. But more importantly, the cancer is more metabolically active. Than before. So basically, it's smaller, but it's getting ready to replicate like crazy. And in the lymph, while the mass is smaller, it's more, um, spread out. Which isn't a good sign.
Kali (silently): No I'd call that a fucking bad sign.
Kali's dad: Right...?
Doctor: So, the chemo's not working, and it's killing your kidneys, so we're gonna stop it.
Kali's dad: Okay...?
Doctor: Instead we're going to go with our second line defence, which is a drug called Tarceva. Chemo had 40% chance of working. This has a 20% chance. It's hard to tell because normally it doesn't work at all in people who've smoked (my dad smoked two packs a day), or tumor cells that don't have this particular genetic mutation (which my dad's tumor doesn't have). But your tumor doesn't have the mutation that DEFINITELY says it's not going to work, so we're going to try it.
Kali: This might seem like a dumb question, but why not finish the course of chemo that you had planned? I mean, if it is killing the cancer cells, maybe it just needs more time to work?
Doctor: We don't want to waste precious time.
Kali & Kali's dad: !!!!
Kali: Wait, tell me again, how is this news MIXED?!?!

Le sigh.

Comments

I Can Sympathize

[britgeekgrrl.livejournal.com]

As my husband's oncologist once said, ten or fifteen years from now, we're going to look back on chemotherapy and current treatments for cancer and say "Wow. That was practically voodoo"

Chemotherapy, for all the good it can do, is still very much hit or miss and based on 'killing the cancer SLIGHTLY faster than we kill the patient' - and sometimes, the latter gets ahead of the former and it's time to change, which is what it sounds like with your dad.

There's still a chance they can put the kibbosh on the metabolically active areas and that's a GOOD thing. That's why it's "mixed" rather than "Frustrating and/or bad"

My hubby's stuck on a plateau at the moment which has us climbing the walls. It won't be until the next CAT scan that we know if it's just the one tumor being stubborn, or maybe it's retreated but a whole bunch of other areas have lit up, instead - in which case, there ain't much mixed about it. Sigh.

*hugs* Good luck.

Re: I Can Sympathize

[kalichan.livejournal.com]

*hugs back* I can't even imagine going through this with a partner. This whole parent thing is BAD ENOUGH. I hate cancer, I hate it. *throws temper tantrum*

And yeah, I can totally see how medical science of the future is going to look back at chemo like we look back at civil war amputations.

Thanks for the hugs and understanding. You hang in there too. I hope things work out with the next scan.

Re: I Can Sympathize

[ophymirage.livejournal.com]

Hi honey - as a reminder, we are all pulling for Alex, & for you too. *hugs*

[genders.livejournal.com]

So sorry about your dad, Kali, and about how difficult the medical establishment finds it necessary to make things.

[kalichan.livejournal.com]

Thanks. I guess they're doing the best they can... but I keep (foolishly) expecting them to be like doctors on tv (you know, sympathetic, helpful, etc.) and that doesn't seem to be the case so much.

But they're overworked, and I get it. And probably there's no nice way to do this kind of thing.

[darthhellokitty.livejournal.com]

***hugs***

[kalichan.livejournal.com]

Thank you. *hugs back*

[villeinage.livejournal.com]

Aw, I'm sorry. Weird doctor-code is weird, yeah?

I wish they were better communicators.

[kalichan.livejournal.com]

Yeah, you'd think they'd learn that in school or something. *g*

[lolliejean.livejournal.com]

Oh Kali. I hate this fucking disease. Thinking of you and your Dad.

[kalichan.livejournal.com]

Oh, hon, you've experienced it so much more up close than me, and you've been so brave, I feel kind of like an asshat for even complaining. *hugs* Thank you for your good thoughts.

[amand-r.livejournal.com]

Oh hon. Hang in there. I wish I could send love over the internets. And pie.

[kalichan.livejournal.com]

You do! In comments! And post-its! *g*

[neifile7.livejournal.com]

Oh lord, this sucks, Kali. A friend's going through something similar, trying to keep the kidneys intact long enough to continue with treatment. Sometimes there aren't many good choices. But yep, communication fail, too.

But maybe, second opinion time? At least in terms of other possible drug options? (Friend recently did this, and it made her feel better even if the news was pretty much the same.)

Sending hugs, and will happily join you in virtual primal scream therapy, if that helps, too.

[kalichan.livejournal.com]

I think you're definitely right. I just haven't had the wherewithal to get it set up, y'know? But yeah. *hugs to you and your friend*

[wordsofastory.livejournal.com]

I wish I could offer something other than sympathy.

*hugs*

[kalichan.livejournal.com]

It helps! Oh, and I have a present for you. *grin* We must all hang sometime soon.

[such_heights]

Oh god, this sounds horrendous - sending all kinds of good thoughts your way. ♥

[kalichan.livejournal.com]

It's pretty awful, but we're hanging in. Helps to blow off steam on the internet, don't you know. Thanks for your good thoughts. ♥ ♥

AND new Leverage tonight. wheee!

[itcamefromjapan.livejournal.com]

I know I don't comment often, and that I've not commented at all regarding this whole thing - mostly for want of the right words. That said, while I've been fortunate enough never to go through this with a parent, I do know how horrifically awful cancer can be, and you and your father are absolutely in my thoughts. ♥

[kalichan.livejournal.com]

Thank you so much. I've a hard time too, commenting on this kind of thing, so I appreciate it. *hugs* You are awesome. =D

[(Anonymous)]

It's pretty pathetic to complain about lunc cancer when you've been a smoker. Just Darwinism at work. The world's better off.

[faris-nallaneen.livejournal.com]

um, EXCUSE me, Ms. Anonymous? I am just going to point out that: a) you're an asshole; b) you're a troll; and c) you're not even very good at being either of the foregoing, because do you REALLY think you have the ability to make Kali feel worse than the actual bad thing that is happening in her real life is causing her to feel? (hint, since you don't seem like the type to figure out the correct answers to things: you don't.)

Pathetic, really.

[faris-nallaneen.livejournal.com]

I love you. big hugs. Have said all I can think of via phone, so... is it consolatory if I tell you that at least your dialogue is excellent, as usual?

[kalichan.livejournal.com]

Compliments are always consolatory. *g* Especially on writing. You got any more?

[invaderwitch.livejournal.com]

You have my sympathy as the child of a sick parent. Hope things take a turn for the better soon.

[kalichan.livejournal.com]

Thank you so much! (And for your reply upthread. It's nice to be reminded that my friends (internet & otherwise) are fucking awesome in the face of douchbaggery!) ♥

[mellacita.livejournal.com]

*many hugs*

I spent a lot of time trying to translate "cancer doctor" into "logical english that makes sense." I wish there was something we could do to help.

[kalichan.livejournal.com]

You do! And I'm terribly, sincerely grateful. *hugs back*

[kel-reiley.livejournal.com]

o good grief, for being so smart doctors are like the dumbest ppl ever
*HUGS YOU TIGHT* am sending all my good thoughts your way - i just fell down the stairs, i'm owed something good, which you can have

[kalichan.livejournal.com]

Yay (on the hugs, not falling down the stairs. Are you okay?)! And thank you! Maybe there can be enough good to go around.

[contrarywise]

Urgh. Boo for medical communication!fail. Not to mention idiotic trolls in comments. *hugs and best wishes to you all*

[kalichan.livejournal.com]

Thank you so much. *oodles of hugs*

[xenakat13.livejournal.com]

I'm sorry to hear the unpleasant news. *hugs* I also wish there was something I could do to help you feel better, but I'm keeping you and your dad in my thoughts.

[kalichan.livejournal.com]

I appreciate it, so much. Thank you.

[qthelights.livejournal.com]

I'm so sorry, honey. Here's hoping that you guys have some luck with the drug. Twenty percent is still definitely possible. *hugs you tight*

[kalichan.livejournal.com]

Yep. We're still hopeful. It was just kind of a bad day. Thanks, hon. *hugs*

[stardragonca.livejournal.com]

I'm so very sorry. I don't know what to say, other than i wish you both well!
Peace and love, health and strength to you!

[kalichan.livejournal.com]

Thank you for your kind words. They're much appreciated. :-)

[definehome.livejournal.com]

Fucking hell, that hurts. I'm sorry.

[kalichan.livejournal.com]

It was pretty lame, but we're not licked yet! Thank you.

[bodlon.livejournal.com]

Oh, *hug*

Seriously. Just *hug*

[kalichan.livejournal.com]

Hey, I get that hug in person soon! eeeep!

[magnetgirl.livejournal.com]

You know, I found that exchange darkly hilarious and also heartbreaking-holy shit you're already writing better than Russell T Davies! (am I surprised? no.)

I love you SO much. And, and-I need to be around more. Let's have at least one date a week, eh? Just pick the day and it's yours. I don't care what work thinks! Eff 'em. Lovelovelove you peanut.

[kalichan.livejournal.com]

Thank you my darling. One date a week sounds like just what The Doctor ordered. lovelovelove.

P.S. re: RTD - awwww. Thank you!