Sunday, June 20, 2010
Sutent = PFD
Bryan surprised me for my birthday by making reservations in Pensacola Beach for a short trip. We just had to check on our beach! We were prepared to find an ugly mess but, instead, found beautiful white sand and clear water. After a detailed search, Bryan found a few raisin-sized "tar balls." I guess I was expecting soccer ball-sized blobs. It was hilarious to watch the official beach cleaners in their haz-mat booties, gloves, etc. Our favorite was a big guy who had a little broom with a dust pan on a stick. He was NOT working up a sweat.
On one of our few outings away from the water, Bryan located a West Marine store. He bought a few t-shirts and got a new catalog. He loves boating paraphernalia as much as he loves boats. In the catalog, there's a whole section on PFDs (personal floatation devices). There's a PFD for every purpose: water skiing, fishing, off-shore craziness, canoeing, etc. The most expensive jackets are the ones that will bother the fisherman the least. It's there to be inflated if necessary, but most of the time, it just feels like bulky suspenders. Good to have but not in the way. Then there are the jackets that include a huge tether; it will inflate itself if the wearer is flung overboard by a big wave. In the fine print in the catalog, the good folks at West Marine state that all children under 12 should always wear a PFD, and if everyone would wear one, there would be fewer water-related deaths. Stick with me. We English teachers love a good metaphor.
We saw Dr. B for our tri-weekly Friday night sit-in-the-waiting-room date. We really should open a bar next door with those radio-controlled devices that let you know your table is ready. We'd make a fortune. Anyway, when we finally had our audience with the good doctor, I asked why the transcript of his latest scans only discussed "representative" mets instead of enumerating all of them. Bless his heart, he really does do his best to answer our questions without scaring us. (Too late.) Here's my synopsis of the answer:
With other types of cancer, patients expect to hear that they've been cured or are in remission. My brother Larry's leukemia was wiped out by the bone marrow transplant. No more cancer cells. My sister Cheryl's breast cancer was eliminated by surgery, chemo, and radiation. Gone, gone, gone. With RCC, however, success is measured by Progression Free Disease. We're not used to playing to a draw. We don't like ties. Five years ago, a patient either got well fast (probably because there was no metastesis) or died. He fell off the boat with no PFD.
The scan transcript shows that Bryan's cancer is being controlled and he has every reason to expect that Sutent will continue to maintain PFD. We don't know how long that will be. When and if it does fail, there's a line-up of other drugs waiting to take Sutent's place. Kidney cancer also seems to be the current darling of research, resulting in amazing new drugs that weren't available five years ago. Even more miracles may be around the corner.
The kicker is the side effects, of course. We love the white hair. The fatigue is manageable. The sore feet create misery for a week or so then get better, and he goes about his business. The side effects are the bulky old life jackets that keep us from moving our arms. But Sutent and its cousins are the tethers that keep us from floating out to sea. We love boating paraphernalia.