Since my last chemotherapy infusion I've been experiencing an increasing level of symptoms from my cancer. The discomfort and pain I've been getting in my stomach and lower abdomen has increased in frequency and I've also been sick a few times in the last week when the pain has been at its most intense. It was no real surprise to me then when my oncologist called me on Tuesday to tell me that my most recent scan showed that the dacarbazine chemotherapy had failed to halt the progression of my cancer. As well as the tumours in my abdomen, the tumours in my liver and lungs have also grown. Time then to discontinue the dacarbazine and try something new.
Up until now all the drugs I've taken to treat my LMS have been classic chemotherapy agents. They act by directly killing the cancer cells. Most classic chemotherapy agents are toxic substances which is one reason why they have such significant side effects. My next treatment will be pazopanib. Pazopanib is not a traditional chemotherapy agent; it works by trying to stop the growth of the blood vessels that are needed to supply tumours with oxygen and nutrients and by blocking the take up of enzymes that are important drivers for cancer cell growth. Pazopanib is taken in tablet form which makes it a lot more convenient than intravenously administered treatments.
Pazopanib has not been formally approved for use in treating LMS in the UK but it has been included on a list of drugs that can be accessed for this purpose through the cancer drugs fund. It's a relatively expensive drug and I really appreciate it being available to me through the fund, if it wasn't for the fund it might not be possible to obtain it via the NHS.
I was very impressed today with the efficiency of my oncologist and the NHS processes. Since reviewing my scan result on Tuesday my oncologist has consulted my cardiologist to confirm that my heart problems don't preclude me from taking pazopanib and obtained approval for funding the drug from the cancer drugs fund. As a result he was able to send me home today with the tablets which I plan to start taking on Sunday.
So how likely is it that my cancer will respond to this new treatment? According to the limited data available around 50% of patients with soft tissue sarcoma were found to have tumour growth blocked by pazopanib. A small number of these patients (< 10%) had some shrinkage of their tumours. At this stage in the game halting the growth of my tumours would be a successful result. The duration for which pazopanib continues to work varies considerably from person to person, looking on the bright side there is a recent study that records one patient who continued to respond to treatment for over three years although this person is very much part of the 'long tail' that often occurs in statistics on drug responses.
Possible side effects from pazopanib are far to many to mention here. My main concern is that it doesn't cause any serious heart problems for me. I will be seeing my cardiologist a week after I start treatment so he can review how I'm doing.
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Katie and I spent a couple of days in London earlier this week seeing family and friends. We also managed to do some sightseeing with visits to HMS Belfast, the Museum of London and London Zoo. As usual we really enjoyed our visit to the capital.
I've not taken many photo's these last weeks however I did get the following shot at the Wildfowl and Wetland Trust reserve at Slimbridge. For those non-bird watchers reading this you probably think of a mallard when you think of a duck but actually there are many duck species that can be found in the UK, most of which have elaborate plumage. This is a Northern Pintail, one of the most elegant of them all:
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