Memoir: It's NOT all Wine & Roses

CHAPTER ELEVEN. TARCEVA FAILS ME: WHAT NEXT?

 May 2012 moved into June and my days seemed to be spent sleeping. The sofa in the television room became my favourite place - but I was fearful that the world was passing me by. I was in a holding pattern, worried that I was wasting a year of my life. And I am sure it was depressing for Ross and our 21 year old son to see me in my pyjamas at five o’clock in the afternoon!

I finished my radiation programme with the 19th treatment in early June. This last ‘hit’ took 40 minutes, with a newly made and more extensive mask prepared for me. Again, it was an interesting exercise. The huge machine travelled around my head, and the bed I was lying on kept changing angles so that the technicians could target the exact spot from where the brain tumour had been removed. As usual, everyone at the Prince of Wales hospital was so kind, and kept me completely informed as to what was happening. It is the tradition at POW for patients who finish their radiation treatment to ring a huge bell in triumph. I declined to do so: I knew my road ahead would be long and probably arduous. I didn’t feel that it was the right time to ring any bell. Didn’t want to tempt fate.

I had been on an anti-nausea drug, Metoclopramide , which seemed to be doing its job: the nausea was only mild, at this early stage - although the drug had given me a mild dose of gastric. The intention was that I would continue on the Tarceva tablets, with which Roche had kindly supplied me again, at no charge; then I would have scans on June 12th to check on the status of the lung tumour. I felt confident, was saying plenty of prayers and crossing my fingers. The rash from the Tarceva was not as bad as I had expected, and the pawpaw ointment that I was applying was calming it down.

Then, on June 12th, there was devastating news, and I knew by the grim look on Dr Chin’s and Beth Ivamy’s faces that we were going to be disappointed. After six weeks on the drug the CT scan had revealed that my lung tumour had stood up to the Tarceva. In fact, it had grown slightly and the scan showed a small lesion in the liver and also on the adrenal gland. Bugger, Bugger, Bugger. There were no cancers in the brain, thank goodness, but I had really been confident that the Tarceva would be my miracle cure. We were devastated. Another disappointment and another crash backwards, into the dark abyss. Into the valley of death. Back onto death row.

“Is it all over then?” I asked Dr Chin, amidst tears, thinking of my four children, and the grandchildren I was yet to hold. “No way,” was his vigorous response, and outlined his next course of attack. He decided to switch treatment immediately to the more usual, aggressive intravenous chemotherapy. Two drugs would be employed in a cocktail: Cisplastin, a drug that contains platinum which binds to, and kills, the cancer cells. It also poisons other, good cells and is so toxic that the nurses administering it wear purple plastic gowns and gloves to alert everyone to its danger. The second drug in my cocktail was to be Alimta, recommended, with Cisplatin, for my type of lung cancer: advanced, stage four, nonsquamous non-small cell carcinoma.

I was very upset, but we knew, with this team of dedicated, clever medical people, that we could fight on. I knew also that Professor McCaughan would not remove the diseased section of my lung without these treatments, as the cancer had shown that it had made itself at home in other parts of my seemingly pristine, fit body. I was to be in hospital for each of the chemotherapy treatments, as Cisplatin is toxic to the kidneys, which would therefore need to be strengthened and reinforced by flushing them with a saline solution for several hours. Dr Chin wanted four rounds of the chemo; a two-day treatment to be administered every three weeks. (In fact, the drugs were so effective, and he was so pleased with the response, that he eventually ordered a total of six rounds; just to be sure.) I was determined not to surrender to this disease, this Thing. If the doctors were not calling it quits, why should I? But I had decided not to worry my sisters, children or friends with this set back, although I did email Leigh Atkinson, in Brisbane.

On the first day of the intravenous chemotherapy treatment I was given a range of injections and drugs to prepare my body for the onslaught of the chemo cocktail. There was a shot of vitamin B12, which was intended to help fight against the expected nausea, along with Stematil. The nurses stressed the importance of my taking Folate daily. And then I was instructed to remember to take 8 mg of Dexamethasone, a synthetic steroid that is an anti-inflammatory and immunosuppressant.

Due to the difficulty of remembering how and when to take this list of helpful drugs, the hospital had prepared for me a spreadsheet. I wondered how less capable people, the elderly, or those who did not speak perfect English, coped with such complexity. I stayed in hospital for two nights on each occasion of my treatment. There was a certain comfort and security in the constant presence of the nursing staff. Treatment21Treatment mask1