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Doctors, Tests, and Treatment

     We went in to see the oncologist, Dr. Nisha Mohindra, at Northwestern, for the first time on April 11th.  She first told us about the results from the MRI, “The cancer did not spread to her brain.”  Hooray for some good news!  My mom was definitely relieved to hear this; we all were.  We talked about possible treatment options and learned that they don’t use the word, ‘remission’ when dealing with lung cancer.  Treatment would be based on whether or not she has a gene mutation, so she would either be starting chemotherapy through an IV the following week, or she would be able to use targeted drug therapy (where the drug specifically targets her cancer cell changes).  Radiation was not an option.  The amount of radiation needed for the cancer in her chest and neck would be too much for the surrounding areas (her heart, for example).  As Dr. Mohindra put it, “You have too much important real estate in that area, and we don’t want to risk damaging it.” She also told my mom that the average age of diagnosis is 71 years of age, so she is a young lung cancer patient.  This is one of the reasons Dr. Mohindra is all about thinking outside the box for my mom’s treatment plan, which I loved.

Even though my mom really liked Dr. Mohindra (after all, she did call her young), we were advised- even by Dr. Mohindra herself- to get a second opinion.  The next appointment was with another oncologist, Dr. Patel, at University of Chicago.  She talked mostly about a clinical trial that she started, but there would be quite a lot involved in a very long process, including radiation (which is something that all oncologists on the Tumor Board at NW decided against), so we all thought about how hard this decision could be.  Chemo or clinical trial.  But none of it mattered.  We finally found out that she did in fact have the EGFR (epidermal growth factor receptor) mutation, which was actually fantastic news.  My mom decided to stick with Dr. Mohindra at Northwestern, so we went to see her again to talk about the next step: her treatment plan.

The best plan, due to the gene mutation, is the targeted drug therapy, Tagrisso- a drug that was just recently (April 18th- the week before this appointment!) FDA approved as a first-line treatment for EGFR-mutated NSCLC) taken as a pill once every day.  Side effects can include skin issues and other things, but her oncologist team has come up with ways to combat those inconveniences.  They took a CT scan right at the beginning of treatment so that they will be able to reassess the cancer in 6-8 weeks (mid-June), but she will also need to go in for a check-up every 2 weeks at Northwestern. At the 6-week mark, we will find out what this particular treatment plan is doing for her, and whether or not we continue with the Tagrisso.

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