But Wait, There’s More

Can I just say that consensus is a wonderful thing? We met with Dr. Giaccone yesterday at Georgetown University’s Lombardi Cancer Center. He is one of the country’s most experienced oncologists working with Thymic Carcinoma. After looking at my many pages and CDs of  screening results, the first thing out of his mouth was: “Option one would be to wait 8-weeks to see the behavior of the tumors.” That’s 3 for 3, as in doctors telling me the same thing. The trifecta. That’s the polar opposite of this time last year, when I had as many different opinions about strategy as I had questions. Dr. Giaccone telling me pretty much exactly what I heard the day before from two doctors at the NCI was comforting and empowering.

There are several advantages to waiting to start a clinical trial, the most obvious being that I don’t have to start taking drugs that will absolutely have side effects. All three doctors want to watch the behavior of the very small tumors to see if I could be a surgery candidate. They expect pretty slow growth at least for now. Surgery is the only way I’ll ever be cured, but it doesn’t look like a viable option right now. PD-L1, Sutent, and the drug in a trial that Dr. Giaccone is running are just tumor shrinkers or stabilizers. I’d most likely be taking them for the rest of my life. Again, since I feel pretty good, there’s no need to bring on feeling bad prematurely.

Both Dr Rajan and Giaccone say they’ve monitored recurrences like mine that didn’t change for months. As in, nothing got measurably bigger. Dr. Giaccone predicts that my biggest tumor, which is about 1.2 centimeters, will probably only grow 1 mm in 8 weeks. All three doctors agree (that’s three out of three, remember!!) that I am not endangering myself by waiting.

Also, immunotherapy and targeted therapy for Thymic Carcinoma and cancer in general are exploding, even in just the last year. Like Dr. Rajan said, 8-months from now, there may be a PD-L1 trial or something similar just for thymic cancer. New trials are starting constantly. My options continue to expand. I just need time. And it looks like I have that. Yesterday, Dr. Giaccone told me that my life expectancy shouldn’t be measured in months, but in years.

So the new plan of attack is to hold. The image that comes to mind is Mel Gibson as William Wallace and his men waiting for the perfect time to attack English troops on the battlefield in “Braveheart,” which I can’t flip past if I see it on tv (and it’s always on some channel. I have seen the whole film or parts of it probably 50 times.) Anyway, William Wallace instructs his men to “Hold, hold, hold,” until he had the enemy right where he wanted them and then he obliterated them. I’m not a patient person. At first, I wanted to start a clinical trial yesterday. But I like good strategy, and this is that. So, we hold. Until December 3rd, when I go in for more scans. And if there’s no or very little advancement of disease and if I have no symptoms, we hold again. Til we attack and obliterate.

Saw this on a sculpture at Lombardi Cancer Center. No matter what you think, he’s still Cancer Warrior #1. I take this as a sign!