THE BLOG
01/24/2014 02:50 pm ET Updated Mar 25, 2014

Postcards From Lebanon: Part 15 in a Series of Cancer-Related Commentary (Cycle 6)

"The trip begins with a kiss..." (Roam, lyrics by Kate Pierson, Fred Schneider, Keith Strickland)

Taking a ride down a split tar, potholed, soft-to-no shoulder, buckled road for my final chemotherapy cycle was not what I had wanted, but having been in and out of the hospital with a fever as high as 104° F, that's exactly the sort of trip I've been on. Which gives me pause as my illness and fever recede and I get better (yet weaker, dizzier, thinner).

Yes, this sixth road trip has taken its toll. I knew that cycle five had left me depleted of energy, but I had not expected to be knocked out for three weeks, and with ongoing chemotherapy-related issues during week four. As you read this, remember this doesn't happen to everyone -- it is my experience -- and let's not forget that I opted for the harshest protocol. I had been told by my doctors that I would feel better before I felt worse, and they were right. The early cycles were super: I was ChemoMan, zapping cancer cells high on steroids. The mid-cycles weren't too bad: I was StonerMan, wacking cancer cells with medical cannabis. But these final cycles have been the road trip from hell -- running out of gas, lost torque and suspension, near total bang up.

Before we crest the hill and head off into the rising sun like a phoenix, it should be noted that there are many positive projects on the horizon to which we should look forward. Perhaps even one or more of these, or a new medicine, will be on the market soon; one can always hope.

As reported here on The Huffington Post, there is a new drug, ibrutinib, that has been approved by the FDA because it has shown to be effective in suppressing the development of cancerous cells as seen in a study for a type of non-Hodgkin lymphoma (mantle cell lymphoma). In a study which included 148 patients of both formerly untreated and relapsed CLL patients, the historic markers are better than what had been previously seen. After 27 months, "nearly all of the previously untreated, or treatment-naive, patients and almost three quarters of the relapsed and refractory patients had no evidence of the disease progressing." It is currently in a phase II clinical trial as noted here in combination with rituximab (an antibody) and awaiting approval by the FDA for CLL. In this study, 95 percent of the 40 participants showed complete or partial responses. The next phase is to include the combination of ibrutinib and rituximab against ibrutinib alone in, what MD Anderson calls its "Moon Shots Program" -- expedited pace of saving lives -- involving 208 previously treated CLL patients. This is very good news, for the longer CLL can be kept at bay, the longer those in the hematology/oncology profession can sustain life.

Another, experimental drug, Abt-199, has shown positive results for controlling or eliminating CLL in more than 80 percent of the participants in a study. And these patients had not responded positively to previous treatment for CLL. You can find information on this program here. As reported at the 55th American Society of Hematology Annual Meeting and Exposition, and information found here, the initial trials of this drug by itself have proved effective. The next phase is to use the drug in combination with other drugs. Something to note is that this drug holds promise for other cancers since it has been shown to block a protein in cancer cells that have defeated a process called "programmed cell death" where our bodies naturally fight off cancerous cells. This is super in that anything which can destroy cancer cells in our bodies without lasting or long term negative effects will be beneficial all around.

An even more promising clinical trial has been undertaken by a research team from the Perelman School of Medicine at the University of Pennsylvania, as reported here. It involves removing T cells from the participant's blood and genetically engineering them to fight leukemia by targeting tumor cells using a protein on the surface of the reengineered T cell which then binds with a protein on the surface of cancerous cells. When infused back into the patient's blood stream the reengineered T cells rapidly multiply and proceed to kill off the cancerous cells, leaving the healthy cells alone, eliminating one of the negative side effects of traditional chemotherapy. The trial was conducted using patients who had exhausted all other forms of treatment -- this was a last resort. It also holds promise for treatment of other types of cancers. While it is quite early in human trails and years off from being available to large groups of patients, this may be the most promising treatment to come along in quite some time.

And we shouldn't forget all the other clinical trials that are going on at cancer centers in the United States and around the world. Private donations are keeping the research funding going here in the U.S. since our government has cut funding for research. We must continue to strive for a cure. Please donate to your cancer center of choice.

So as I watch the heat waves ripple off the blacktop, I'll continue down the highway with the top down and windows open so the wind can brush my newly grown hair.

Timing: Check-in at Dartmouth 27-Jan & back to work 1-April (April Fools).

Oh, and Nancy Philips and Elizabeth Kuster have been added to my list of angels here on earth.

Ride the arrow to the target....

Postcards From Lebanon: Part 1 History
Postcards From Lebanon: Part 2 Vincristine Study
Postcards From Lebanon: Part 3 Prep for Chemo
Postcards From Lebanon: Part 4 Cycle 1
Postcards From Lebanon: Part 5 Neutroponic Fever
Postcards From Lebanon: Part 6 Nadir Charts
Postcards From Lebanon: Part 7 Cycle 2
Postcards From Lebanon: Part 8 How People Respond
Postcards From Lebanon: Part 9 Cycle 3
Postcards From Lebanon: Part 10 Medical Marijuana
Postcards From Lebanon: Part 11 Cycle 4
Postcards From Lebanon: Part 12 The Infusion Room
Postcards From Lebanon: Part 13 Cycle 5
Postcards From Lebanon: Part 14 Christmas with Cancer