Biohazard!

If it's biohazardous, it's gotta be good.

Karen's crizotinib arrived this morning via an unnervingly cheery UPS man. Thirty days worth of the medication was inside the box, nestled in a ziplocked bag sporting a bright yellow biohazard symbol. Now, as a general rule of thumb, we have made a point to avoid anything sporting a skull and crossbones or a bright orange radiation bloom or the curving thorns depicted just to the left, but on this day we happily tore into the bag. The medication had arrived early enough in the day that Karen would just be able to shoehorn in the two doses she'll be taking daily. We cracked open the bottle and Karen swallowed her first dose, a thick brown capsule that fell just short of being a horse pill.

At this point we reviewed all the literature we had about the drug to make sure we were on the alert for any unusual side effects and properly prepped to deal with the expected ones. I organized Karen's assortment of anti-nausea meds and went over which could be combined and which could not with Miranda. I also showed Miranda how to grind up Karen's medical weed and load up her vaporizer. Not quite the sort of father-daughter moment I thought I'd ever have but there you go. My little girl is all growed up and ready to pump her mom full of weed.

Within about 20 minutes of taking her medication, Karen felt pretty nauseous. That was pretty quickly subdued with a couple of anti-nausea meds. With her treatment officially underway, Karen settled in on the couch, wrapped herself up in a couple of blankets, and started watching Live Free or Die Hard. Unfortunately, the crizotinib has not yet had an impact on her deplorable taste in movies.

So now it's a waiting game. 60% of people that test ALK+ like Karen respond to the crizotinib. In this case, response means a cessation of tumor growth and some actual shrinkage of cancer. Assuming this happens, Karen should be able to breath easier and have some energy return. This could happen in as few as three weeks but four to six weeks is more likely. At some point after that she will get re-imaged, meaning there will be more scans to view the tumors and see if there has been any measurable progress. In the meantime, we will be on the alert for any of the more alarming side effects as well as more expected ones like double vision. One good thing about this drug over Tarceva (aside from the better response rate): it won't cause you to sprout eyelashes on the inside of your eyelids. *shudder* That just freaks me out.

Feel free to cross your fingers along with us.

STATUS UPDATE

• Karen has begun taking crizotinib, a targeted therapy that the 3% of people testing positive for ALK mutation can take.
• 60% of people on crizotinib have a positive response.
• A positive response includes a halting of tumor progression and even some tumor shrinkage.
• Karen could feel better in as few as three weeks although a wait of four to six weeks is more likely.
• Common side effects include nausea, vision problems, diarrhea. At this point, Karen is just experiencing nausea which is being controlled with anti-nausea meds.
• Our daughter is now a trained drug dealer.
• Karen has terrible taste in her preferences for cinematic "comfort food."