Tuesday, August 19, 2025

Round Four

I've now started Cycle #4 of the Keytruda/Padcev combo therapy. According to the online buzz, this is about where we see whether things are working or not.

Yesterday, Laura and I met with Dr. Noonan (oncologist) who agreed, and is in the middle of scheduling a CT scan to see where we are (note a CT versus a PET - apparently the CT shows better definition for measuring sizes of stuff). (NOTE: CT scheduled for Sept 8).

In populations getting this combo (stage 3/4 urothileal cancer), they see about a 30% total response. Which in doctor-talk, means when they do a CT after several cycles (like me) they cannot find any trace of cancer. So that's hopeful. If they don't find anything, we scale back and go on some kind of a maintenance program - sort of like your hot water tank.

But of course, what about the other 70%? With some, there is no response at all, and the tumour(s) have continued to grow. With others it has either stayed the same size or shrunk. If either of those things happen, then we rethink.

I'm trying not to get ahead of myself and be either hopeful or pessimistic. It just is what it is, and we'll pivot just like we have every other time.

It feels as though we're trapped in this "holding pattern" - waiting for the next shoe to drop. But when I think about it, it's like having a job you don't really like. You do it because you have to do it. 

My favourite quote lately is from Mike Tyson: "Everybody has a plan until they get punched in the mouth". Seems topical.

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