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.

[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***

[villeinage.livejournal.com]

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

I wish they were better communicators.

[lolliejean.livejournal.com]

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

[amand-r.livejournal.com]

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

[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.

[wordsofastory.livejournal.com]

I wish I could offer something other than sympathy.

*hugs*

[such_heights]

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

[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. ♥

[(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.

Re: I Can Sympathize

[ophymirage.livejournal.com]

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

[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.

[rm.livejournal.com]

The world does not work on a points system. While some of us apparently have to learn the ability to have compassion for others, compassion from others should not need be earned, but is rather granted by our shared mortality and humanity.

There are, hopefully, medications to help in Kali's father's condition. There are, sadly, none to help you in yours except the frequent cruelty of life experience. May you be so lucky as to avoid those lessons, even if, annoyingly enough, that means you're going to keep being an asshole to the rest of us.

[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?

[invaderwitch.livejournal.com]

Did you really just tell someone the world would be better off without their father?

Kindly DIAF.

[invaderwitch.livejournal.com]

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

[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.

[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

[itcamefromjapan.livejournal.com]

I'm trying and trying, out of the goodness of my heart, to find a way in which this comment is even remotely appropriate...

Nope, sorry. You're a douche. Goodbye, then.

[hofnarr.livejournal.com]

Ok, trollfail. Do you even know what Darwin meant? As Kali's father has obviously already reproduced, him being in ill health NOW means absolutely nothing. Douche.

[kalichan.livejournal.com]

Thank you. *hugs back*

[kalichan.livejournal.com]

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