Godzilla, Part 1

A week and a day ago, I embarked upon the newest adventure. Kadcylla. Since it rhymes with Godzilla, that is what I've been calling it. It is an antibody-drug complex (ADC) also called a targeted chemotherapy. I remember reading about this a couple of months ago and thinking, "Wow, what a fascinating and powerful way to kill cancer cells," with the next thought, "Sure hope I don't have to go on it, though."

Kadcylla is the monoclonal antibody traztuzumab (a.k.a. Herceptin) attached to a chemotherapy drug called emtansine which never made it through approval as a single agent in the past since it is so very toxic. The antibody targets the HER2 receptor which cancer cells overexpress 200x more than normal cells. Once attached, Kadcylla is taken in by cancer cells. Lysosomes within the cell break up the antibody-drug complex releasing emtansine. Emtansine then breaks up microtubules within the cells preventing them from multiplying and causing them to die. 

One might ask why I would have to take this drug when last month's surgery removed all of the breast tissue and the tiny bit of remaining cancer along with it. Well, what is called adjuvant therapy is now standard of care for so many cancers. What we know is that occasionally cancer cells escape their original location and go elsewhere in the body. This is a particular feature of HER2+ breast cancer which has a tendency to recur with metastases even if caught at an early stage. My stage 2a was downstaged to stage 1 at surgery; yet, even with the best modern therapy there is at least a 10% risk of recurrence which would be a mortal circumstance. The risk would be double that without Kadcylla. 

Godzilla may not be quite the right literary or cinematic figure with which to compare Kadcylla; yet, there is quite a lot of banter going around these days about which novel we are all finding ourselves trapped within. 1984, Fahrenheit 451 The Brave New World or The Great Gatsby have all been brought up. Dystopian literature is making a comeback in these dark times. 

For me, the initial infusion with Godzilla was not much of a confrontation. I am grateful to have recovered so well from surgery so far and also be relieved of the terrible side effects of phesgo. I am also glad that my eyes have fully recovered to the point that I am able to again read about one novel a week. I have had some trouble sleeping and queasiness which I am hoping my system will straighten out. I have one cycle down and thirteen more to go, every three weeks into next year.

Praying people, please pray for the following:

1. For Kadcylla to eliminate every single cancer cell anywhere in my body.

2. For my eyes, heart, liver and blood system to be protected from toxicity.

3. For my sleep and my energy and wisdom about how and when to rest and when to press on to build my strength.

4. For my return to work starting with a couple of sessions of TeleVisits next week and then in-person visits starting on April 21st.

5. For my family to stay healthy during this time. My mom is having a heart procedure in May, and I will be traveling out to Colorado to help her then.

6. For the practice to thrive even with a number of transitions coming up and that we would be able to hire another part-time physician to join us soon along with other key support staff.

7. For God to use this season of suffering and challenge to help me know Christ more deeply and to grow in wisdom, spiritual strength, and joy.

I am so thankful for all of the love, help and support I have been receiving. It is truly humbling, hard to receive help, but clear that I have needed it!