Update, 3/17: We met today with the oncologists just before Stu had his chemo infusion. Unfortunately, all the tissue and fluid harvested during the biopsy was required for the genetic testing so Stuart Little will have to wait until there's another opportunity to collect some tumor cells. The good news is the chemo infusion went well and Stu is already feeling a bit better. More to come in a few weeks...
Last Friday Stu had his surgical lung biopsy. The procedure went well and there were enough cancer cells in the pieces of lung that were removed to enable genetic sequencing. That will take about three weeks and, hopefully, will provide insights on how his cancer got around the previous two therapies, and what may make the most sense for his next course of treatment.
Another activity the oncologists are pursuing is to create a mouse model of Stu’s cancer. In this still quite new process, a mouse with a suppressed immune system is injected with Stu’s cancer cells. Once the cancer cells “take,” the oncologists can then work on developing treatments that successfully inhibit progression of the mouse’s cancer, with the hope that they may do the same for Stu. This avenue is more of a long shot than the genetic sequencing, but there is no risk in opening multiple lines of inquiry. The same reasoning will have them starting a cell line which will allow them to test various compounds against the cancer cells in the laboratory.
The oncologists were on top of things, as usual, and preserved the fluid that was drained from the lining of the lung as a source of cancer cells for the cell line and mouse model. Incidentally, we’re hoping to visit the mouse when it’s “created” and Stu has already named him (or her) Stuart Little.
Back to the surgery: Stuart spent two nights at the Brigham for observation as his blood oxygen levels were quite low. This really wasn’t much of a surprise as he’s enduring the dual effects of surgery and progressing disease. In fact, he’s not been on any treatment since last Tuesday, so we’re very anxious to start something as soon as possible.
Stu came home Sunday on oxygen. He will continue to use oxygen until he can sustain normal blood oxygen levels without it. He is feeling better but continues to need pain medication pretty frequently and tires easily. A visiting nurse saw him Monday and will come by twice a week, probably until he’s off oxygen.
As I mentioned, our most immediate concern is to get Stu re-started on treatment. He is feeling very vulnerable having not taken anything for over a week, and we should not expect his oxygen levels to recover until at least some of the disease in the lungs is cleared up. Since we know the experimental drug, lorlatinib, stopped working (at least in the lungs) several weeks ago, he will start up liquid chemotherapy, with his first infusion tomorrow (Mar 17). It will be the same cocktail he received last August (carboplatin and pemetrexed) to which he responded well. Hopefully, he will again.
Thanks to everyone who checked in pre-, during, and post-surgery. Even if we didn't take you up on all your generous offers of rides, meals, or anything else, we truly appreciate them. I tried to respond the best I could to each of you and apologize if I missed anyone. Thanks again for your continued support and love. I will, as always, try to keep you updated on our journey and where we go from here when that information is clear.
For those who are wondering, a card, an email, or a text is always okay! We so appreciate your kind words even if we are unable to respond to them all. Until then...