blood test results

We went to Dr. Brigdon yesterday for Mom’s blood test results.

DNA – As it turns out, the blood test was not conclusive.  They were looking for a particular protein sequence shape within the DNA of the cancer cells.  They couldn’t find any cancer cells in the blood to get any DNA from because the cancer has been, so far, isolated in her lungs.  They need the DNA from the cancer cells to test whether or not there is a particular type of cancer cell mutation.  It’s very similar to the med she’s on now but creates a different shape of protein connector to attach to the rogue (cancer) cells to kill them off.  It’s the same but different.

biopsy – So the next thing is a biopsy of material around the lung to actually get a cancer cell sample.  The biopsy is about a 20-minute procedure with a 3 or 4 hour rest in hospital afterward.  It’s a “neo biopsy” – taking liquid from a cavity.  It’s painless.  She had this done before (2014-09).

They would poke a probe (large needle) into the cavity between the lung and chest (the pleural space) and extract fluids.  They would be able to get cancer cells and extract the DNA from them to test whether or not this new medication would work.  It’s still no guarantee that it would work, but the cancer cells have to be tested before this new med is dispensed.

The last time they talked about this, maybe a year ago or so, the doc said, “You’d die on the table.”  Now he seems to have a completely different view of it.  It seems to me, being at the meeting this time, that confusion abounds and things got mixed up in many other meetings; it seems to me that they might have been talking about two different procedures.  Nonetheless, the opinion of the doc (Dr. Brigdon) is that this procedure is entirely possible.

There is a 3~4% chance that she would experience a pneumothoraxing (collapsed lung, where the pleural space gets filled with air so that the lung can’t suck air into itself when the entire cavity is expanded – air gets into the cavity instead of the lung).  This is especially true with people with breathing problems, like COPD.  If this were to happen, she’d spend that night in hospital and be released the next day.  If not, then she’d go home right after the procedure.  There’s no general anaesthetic – just a local freezing of the needle entry area.  They’d give her Gravol.

The biopsy would be sent to Calgary, not Toronto, and would would give results within a week.

new med – The hope is that the new med will work.  If the cancer cells have mutated in this way so as to make the current medication not work, then this new med will work.  The doc says that “there’s a fairly good chance” that the current med has stopped working because of the mutation and has probably stopped working a few months ago or, at best, kept the cancer at bay.  This is not a bad thing because it is evidence that the cancer cells have mutated – mutated in such as way that the new med will work.  There’s about a 60~70% chance that this mutation has occurred.

Since the old med (and new) was expected to work for 1 to 1.5 years and has worked for about four years now, and since the new med works in the same way, there chances are the new med will also work for a few years.  It would be taken the same way her old med is – 3 or 4 times / week.  And, if the DNA mutation does exist in the cancer cells and Mom starts taking it, there is at least a 50% success rate with this new med.

decision – Mom has decided to go with this procedure.  She asked, “Is this dangerous?”  The doc answered, “Well, yes, but dying is dangerous, too.  It all depends on how much danger you want to put up with to extend your life.”

The side effects of the new pill “should be no different from the one you’re on now”, the doc said.

“I don’t know if you know this or not, but…” Mom asked.  “It might be a stupid question – if I did what you’re talking about, would I live longer?”  “Oh yah, Dr Brigdon answered.  “I mean if you have the mutation and you went on this other pill, … people often go into remission for another year or two.”  So, it’s kind of a no-brainer for Mom.

The rest of her health is good.

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