I read a news release this last week about an article published in the International Journal of Cancer about survival improvement in people with stage IV lung cancer and bone metastases who are treated with Zometa. It was a small study and the patients were put on the Zometa for bone pain. Turns out it didn’t help the pain, but overall median survival in the group treated with Zometa was over 19 months, while survival for the chemo only (carbo/taxol) was just over a year.
That’s a big difference! In fact, I will reach the Zometa group’s overall median survival on Sunday. My oncologist started me on the Zometa months ago when I started to develop new bone lesions. As you know, I’m on pain meds to control the pain, but we’ve continued the Zometa to try to prevent more new bone lesions and to delay time to fracture of any that I have. At least a part of me feels like the Zometa is playing a significant part in keeping me alive and keeping me active.
Which brings me to the good instincts part of this post. When I was first diagnosed I was referred to a local general oncologist. He recommended the current gold standard chemotherapy - carbo/taxol/avastin. I then started the process of getting a second opinion from a large cancer center. They were very supportive of using Tarceva first in nonsmoking women. My liver function tests started to deteriorate rapidly and I decided, with the original oncologist, to proceed with classic chemotherapy. Since then it has been shown that patients who don’t have the EGFR mutation (I don’t, but we didn’t know that at the time) actually do worse when treated first with Tarceva. So my oncologist has made two very significant decisions regarding my care based on what was incomplete information at the time but what turned out to be very good instincts on his part.
So much of this cancer story is luck and biology. Once the really bad luck part got me (being diagnosed with stage IV lung cancer to begin with), it’s nice to have gotten a couple of breaks on the luck side in treatment and survival.