Wednesday, March 18, 2015

Mom's Cancer Recurrence 2015

As I wrote about on the blog, in August 2013, my mother was diagnosed with renal cell carcinoma, the same kind of kidney cancer my dad had. It was contained in the kidney, so she had surgery in October 2013 to remove that kidney. My dad had the same surgery for the same reason in April 1999, and his cancer returned 11 years later so I didn't assume she was off the hook, and suggested she upgrade to a serious renal cancer oncologist, which she did.

Nana Visits- Feb 2015
With her grandbabies

The new oncologist had her get scans every 6-months, and two scans later, in February , we found out the cancer had returned. This time she can't have surgery, because when it comes back it's always stage 3 or 4. But as we already knew because of my dad, chemo and radiation don't work on kidney cancer either, so the general treatments are targeted therapies usually in the form of pills or IV drugs.

She enrolled in a phase II trial, testing Cabozantinib. We were hoping that she would get the new experimental drug, but instead she got the control, Sutent. Typically, Sutent the drug they'd put you on anyway, the "first line" drug. We were just hoping for something else because Sutent was so ineffectual on my dad.

If you want to understand more about the treatment, keep reading. Otherwise you can stop now.

Each drug has a generic name and a trademarked brand name. My mother is on sunitinib malate, brand-named Sutent. Sunitinib/ Sutent is an angiogenisis inhibitor. For malignant tumors to expand and metastasize, they must be able to form new blood vessels by a process called angiogenesis. Tumors overproduce “growth factors” that stimulate the development of new blood vessels to supply oxygen and nutrition. These include “vascular endothelial growth factor” (VEGF) and “platelet-derived growth factor” (PDGF). These growth factors activate certain proteins inside cancer cells to develope new blood vessels. This allows tumors to grow and to metastasize to other parts of the body. Angiogenisis inhibitors, such as Sutent, inhibit the growth of the blood vessels. Additionally, Sutent may shrink tumors instead of merely maintaining.

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