It’s been a while ….

My last post was in early December 2024 when I started taking Tagrisso (the targeted therapy drug osimertinib). I was struggling a bit with the transition from “intense, life swamping treatments” to “onward and upward – managing life with cancer”. Then there was the festive season and now it is almost a month later. So what has been happening? Mostly good things, so here is a summary.

Radiation oncologist consult 16 December: We attended a consult with the radiation oncology team (16 December, 2024) and discussed the results of the latest CT scan (12 December, 2024). The report is in the “More details” section. (I also posted an annotated version because the report is full of medical terms, many of which I needed to look up). Essentially the report records what we had anticipated. The chemo-radiation treatments did not remove all the cancer but they decreased the size of the tumour and reduced the activity in the lymph nodes. The doctors think that the cancer killing impacts of the chemo and radiation treatments will continue for a few more months. Hopefully we will see continued reductions in the next CT scan which is scheduled for late March 2025. The next radiation oncology follow-up consultation is a 3-monthly, 24 March 2025.

Life with Tagrisso

Medical oncology consult 20 December, 2024 The consult was to assess impacts of Tagrisso (osimertinib) which I had taken since 3 December, 2024. The excellent thing is that after taking the drug for almost 3 weeks I did not have any severe allergic reactions, nor major adverse effects that would force cessation of the treatment. 

I did experience some side effects: (1) acne-like rash complete with pimples on forehead, around nose, and on cheeks; (2) mild diarrhoea (always a joy); (3) nausea/stomach cramps; (4) some soreness in oesophagus. I requested preventative prescriptions in case any of the symptoms became worse over the Christmas / New Year period and the doctors agreed. They gave me prescriptions for the rash, diarrhoea, and recommended Buscopan for stomach and paracetamol for the oesophagus.

Medical oncology consult 14 January, 2025 

I had a followup consult with the medical oncologist, Dr Melvin Chin, 14 Jan 2025. I had blood tests a few days before and the consult was to check how the systems of my body were responding to Tagrisso and to check on the severity of side effects that might have emerged.

The blood tests were good. They showed that liver and kidney function was normal and that although some blood cells were lower than normal, all were on the road to recovery after the onslaught of chemoradiation. This was good news. 

As for side effects, the rash and diarrhoea have gone. The stomach issue is a mystery. It is uncommon for patients to have issues like mine so late after treatment. I discussed trying to get the bacteria in my stomach back to some normality and doctor agreed that it was worth trying. He also said that we would monitor the progress at next consult. As I have said before, we are all individuals and each body has differing reactions to medications and treatments. I am grateful that although I have had, (and some days still have), my trials, they are nothing compared to what other people suffer. 

I told the doctor about a nose bleed that occurred unexpectedly on Thursday 9 Jan 2025. It was weird – my nose just started bleeding. The doctor double checked the platelet count and advised that the bleed was not caused by the platelet count being too low. Another mystery. 

Adverse side effects: I asked whether additional adverse side effects were likely to emerge sooner or later. The good news is that the doctor believes that the side effects that I have now are the extent of what will happen. Of course, he cannot guarantee anything, but in practice, severe allergic reactions emerge in the first week of using the drug, and major adverse effects typically emerge in the first 2-3 weeks. He said it is common for the rash and diarrhoea to erupt in the first couple of weeks and then subside or disappear.

Travel: I asked the doctor, “Can I travel overseas?” Without hesitation he replied “Yes”. His instant affirmative reply was INCREDIBLY reassuring. It was amazingly healing to my weary heart and sometimes sagging wellbeing. I am not ready to jump into weeks of overseas holidays like we usually do, but it is good know that I can travel if I feel up to it. The 15 day New Zealand trip with the bike group in March 2025 will be a bit of a test for me.

Unexpected kindness: Another lovely thing that the Medical Oncologist (Dr Melvin Chin) said at the end of the consult was something like, “I did not know you when you were well before. I have only seen you since you got the cancer diagnosis. You look very well now.” 

Those two small things have had a major positive impact on me. It was not so much the actual words themselves, but the genuine manner in which they were expressed in the context of a medical oncology review. My take home from the consult was “You are doing great Dennis”. I still feel like I have a time bomb inside me that can explode at any time. And being realistic, one day the scan will show that the cancer cells have developed resistance to Tagrisso and the cancer is growing. When that might happen is unknown – likely to be years, but could be shorter, it depends on the particulars of my body. For now, I will gird my loins, build my stamina and confidence, and get on with living, enjoying, and getting the things done that I want to get done before my time is up.

Thanks to all for travelling the journey with me. Love yous!