A New Chapter

I've had to be patient entering the "next chapter" in my care.

The chapter started with a transition from my surgeon (thank you Dr. Yamzon!) to an oncologist who specializes in kidney cancer, Dr. Sumanta Pal. Dr. Pal is the reason that we chose City of Hope in the first place. He has quite the CV and reputation as an expert in renal cell carcinoma.
My initial consult was on October 11. We talked about the pathology report in some detail. The final pathology results is that I have a type of cancer called Clear Cell Renal Carcinoma.

Apparently, I have some type of genetic mutation that is found in a lot of people who have this type of cancer. The prognosis is that there is a 30-40% chance the cancer will reoccur as Clear Cell Carcinoma in other areas of my body (lungs, brain, lymph nodes).

The current standard of care for my situation is immunotherapy using pembrolizumab (Keytruda). Immunotherapy uses drugs to boost a patient's immune system to attack and destroy cancer cells - kind of the same way a vaccine attacks viruses. Immunotherapy has some side effects, but nothing like chemotherapy, since with immunotherapy, my immune system is at work instead of chemical toxins. Use of immunotherapy has shown to reduce recurrence another 30%-40%. So, if we do the math, immunotherapy reduces the chance of recurrence to 20%-30%. I'll take any advantage I can get.

The reason for the delay in starting immunotherapy was that Dr. Pal recommended that I take part in a clinical trial of a combination of pembrolizumab and another drug that specifically targets Clear Cell RCC in people with the genetic mutation that was discovered by pathology. We've been waiting to hear back if I was going to be accepted in the study. A bunch of labs, some CT scans, and a nuclear bone scan later, we found out yesterday (11/2) that I'm not. The good news is that the scans show that at this point, I'm cancer free (yea!).

So, immunotherapy starts next week. I'm eager to see the plan - all I know at this point is that I'll be getting infusions every three weeks for the next year. I'm sure there are going to be Oh joy. I guess I'll get used to the drive to Duarte. At least Donut Man is on the way home.

Stay tuned!