apologies in advance for being practical here, but here goes. my mom was diagnosed with stage 4 lung cancer recently. much of the information assumes you have a small cell, or LCNEC because of the speed of the spread and the fact the cancer was only discovered in stage 4. so, the fight is still being fought, but at the risk of sharing things you already know:
- foundation one is considered the best genetic mapping. their result document is great, with every mutation being mapped to a specific treatment or clinical study, if exists. if you are a never-smoker, this could be effective as single mutations like EGFR are your friends.
- the back pains are likely because of cancer around the spine. radiology was surprisingly effective at reducing this pain. don’t quickly go for pain medicine. the problem with almost all other treatments is they make you not want to eat, and starvation is your biggest enemy. EAT. take the opportunity to indulge with all your favorite non-healthy food you always wanted.
- immuno-therapy is effective. namely opdivo / keytruda (sp? i am offline right now, but both operate through a similar mechanism: PD1) to the level it’s questionable whether it’s worthwhile going through chemo first. this would depend on your insurance and/or doctors as they might define this as a 2nd line treatment. argue with them, as chemo weakens your immune system, while these two put it in overdrive and try to have it target your tumor.
- clinical results in recent months have shown that combining the pd1 medicine with another biological medicine called yervoy is very potent. think of it as something that tickles your cell to exhibit more of what makes these medicine work. it sometimes doubles the response rate of the immuno therapy drugs.
- there has been a mentor breakthrough with a dll3 targeting therapy called Rova-T. google for it as stemcentrix that developed it was acquired. there are active clinical studies right now. if you have small cell and you can get into these studies, it’s worthwhile.
most important is not to listen to any time estimates. you’ll be hearing and even WANT to hear that as it provides some system to the madness. don’t listen. it’s meaningless — the real answer is that nobody knows. you have the time.
one other thing — people will want, need, default to being sick through you. don’t let them. this is yours, and you need them for support, not pity.
i am at firstname.lastname@example.org if you ever need anything.