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Oncology 11.3

Treatment options for myself are rapidly running thin, and the latest news subtracts rather than adds to the arsenal of potential regimes. I have finally got the results back on the K-ras testing that I had done on my resected cancer a month or two ago. The sample had to be sent to Australia for it to be done. The results show that my cancer is in fact the mutant variant of K-ras gene.

What this actually means is that the 3rd line option for treatment, which incidently isn’t funded by pharmac and would have cost 3000 dollars per round, Cetuximab, will not be an option. In the bowel cancer population, generally speaking, about 60% of patients have the wild-type variant (i.e. the naturally occurring gene) and 40% have the mutant variant. The mutant varient has been shown to not respond to Cetuximab. Cetuximab is a monoclonal antibody directed at the epidermal growth factor receptor (EGFR) and inhibits it. Monoclonal antibodies are some of the more recent attempts at finding drugs that specifically inhibit receptors known to play a key part in cancer development and cellular reproduction. On the whole, they show a lot of promise in helping extend survival rates. Although cetuximab hasn’t been shown to change outcome, it has been shown to extend survival for an average of a few months (over large population studies). Avastin, also known as Bevacizumab, is another similarly targeted drug (also not funded in NZ by Pharmac) that has shown a similar response. This one binds to the vascular endothelial growth factor receptor (VEGF), and exhibits a similar kind of response by inhibiting angiogenesis (the formation of new blood vessels that cancer requires to maintain it’s supply of oxygen).

Basically what this means is that the 3rd line option for treatment (what I might go to when my current regime fails), which was never funded anyway, is no longer an option. It also means that when this current regime fails, we are really playing the guessing game as to what might be useful next in the treatment of my cancer. This makes the future, and the treatment it might involve, a very big unknown. There are some interesting studies and possible options in the states at the moment, but they will have to be funded privately, and there is no guarantee that any of it will work.

So, I guess Hannah and I will cross the bridge of next line treatment when we get to it. In the mean time, I am continuing with FOLFIRI until a CT scan suggests that I should be doing otherwise.

Until next time…

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  1. Murray Fenton
    June 13, 2011 at 11:08 pm

    How would one get on when they have no knowledge, I guess that you have the advantage of knowing all options that are available to you, it most be really hard on those that do not understand things the way you do as a Doctor, I guess sometimes the same could be said about no knowledge or little knowledge being the better option.
    Hey jared at the end of the day it has been an amazing journey and I can only hope and pray that you will be around a long time yet and I hope that every moment you and Hannah get to spend together is one of pure joy. You are an inspiration and it is great to see that you have a wonderful wife to share the journey and your life with you
    may God Bless you both

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