Day 1

Well, that was unexpected. Monday we received a call that we were all clear to start and penciled in the schedule for today. A full biopsy report won't be available until later this week, but during the procedure last Friday they pulled in a pathologist to "eyeball" the samples to get clearance for the go ahead. Even though it is ultimately "bad" news, it wasn't entirely unexpected. More of a relief than anything else, just being able to finally know 100% what we are dealing with.

So yeah.... today is Day 1. As of right now I've taken my first dose.

I guess the big question is what exactly is it that I am doing. I mentioned before that I am taking part in a clinical trial. For those unfamiliar with how these work, doctors from different parts of the country find suitable candidates to use as guinea pigs to measure the efficiency of the treatment. I am probably making it sound a lot worse than it is. There is always risks, but they usually test on lab rats first for severe toxicity before moving into humans. So while there are some inherent risks involved, steps are taken to ensure the safety of the participants.

For any medical geeks out there following along and want to see what I am doing, you can find all the research study information here.

For the rest of you just following along, here is what I am up against. I will be taking two different types of treatments sequentially; the first one for six weeks and then the other as a follow up. Both of these drugs already have FDA approval for use individually, but the trial I am enrolled in was designed to test the safety of using both in conjunction with each other.

The first drug is called vemurafenib (known as Vem for short or under it's brand name: Zelboraf). The other is called ipilimumab (Ipi for short, brand name: Yervoy). While I may end up using these names interchangeably, I will likely stick with Vem and Ipi for my shorthand.

While the main goal of the trial is to see what happens to my body when I take them, obviously a big part of this is to see what effect it has on my cancer. Both treatments individually have been great breakthroughs in the field of cancer research; only recently (as of 2011) been approved for FDA use, with each having their own set of risk-benefit options.

Vem works by blocking an enzyme produced by a mutated gene in the cancer cells. By blocking the enzyme, the drug causes the cancer cells to stop replicating and allows for the eventual natural death of the cancer. It has a high success rate in patients with this mutated gene, but the drug often fails in the long term because the cancer develops a resistance to it.

Ipi works a bit differently but still uses my bodies own immune system to fight. Your immune system is designed to fight foreign bodies (including cancer), but would attack healthy cells too if not left in check. Ipi tells my immune system to turn off this inhibitor, which "takes the brakes off" my immune system, allowing it to find the cancer easier.

The hope is that working together, they will deliver a one-two punch to knock the cancer on it's ass. The Vem should come in and work it's magic, weakening the cancer and making it susceptible to my immune system. The Ipi will follow up behind it and deliver the death blows with an overcharged response. At least, this is what we want to happen assuming the treatment is effective.

Both drugs are considered immunotherapies, as opposed to the standard chemotherapy used in most cancer cases. While the side effects are often not as extreme as what is seen with chemo patients, there are a few risks involved. While taking Vem the biggest concern I will be looking for is skin conditions, mainly stuff like rashs and small skin lesions. There is also a chance of extreme photosensitvity, meaning I will turn into a vampire and burn quite easily in the sunlight. Due to how Ipi works, the biggest concern is my immune system attacking my body. It mostly targets the gastrointestinal tract, causing poop issues and in some cases colitis.

There is always the chance of having a severe side effect which could put me in the hospital, or even likely cause death. But these chances are very low and are only stated because of the effects of the drugs during initial trials. Most of the side effects can be handled without a hospital visit.

I will go more in depth with the specific drugs later.