It has been a rough couple of months. I began taking Tarceva on Tuesday December 20, once a day, and I have been experiencing some of the common side effects, including fatigue, upset stomach, skin sensitivity, and a rash. I understand that the rash is a sign that the drug is actually working, so I can’t complain too much. I have checked with a variety of top lung doctors, including Sloan Kettering and Dana Farber, and they are all in consensus that my present course, taking Tarceva for as long as it is effective, is the preferable one for my condition. Every person reacts differently. This is not a curative therapy, however. Many people eventually develop resistance to this drug. Hopefully by that time there will be alternatives to Tarceva.
On March 7, the doctors did a ct scan to check my lung in detail to compare with a previous ct scans of 11/17/2011 and 11/22/2011. The results revealed some shrinkage:

“Chest: The previously identified 16 x 15 mm lobulated, speculated mass in the posterior subapical right upper lobe has decreased in size, now measuring approximately 8 x 9 mm (image 21) at its most prominent point. Additionally, the superior portion of this lobulated mass, which previously measured approximately 19 x 7 mm, has also decreased in size and now measures approximately 14 x 7 mm. The previously described subpleural/pleural nodules prominent in the right major and minor fissures have also regressed significantly, and now appear as subtle faint lines. The previously noted 2 mm subpleural nodule in the peripheral right middle lobe has also regressed to a small linear area, which now likely represents an area of scarring.
There is a small, residual right pleural effusion. There is also a small calcified granuloma in the peripheral right lower lobe. The previously described 11 x 11 mm right extrapleural nodule seen at the level of T4/T5, lateral to the neural foramen, is again identified not significantly changed from the prior study. The other multiple, small nodule in the extrapleural fat are less apparent and linear, and likely represent small vascular structures.
Impression: Interval decrease in size of the lobulated, spiculated posterior subapical right upper lobe mass from approximately 16 x 15 mm to 8 x 9 mm.
Interval regression of right subpleural and pleural fissural nodules.
Small right pleural effusion
No significant change in 11 x 11 mm nodule in the right extrapleural fat. As described previously, this may represent metastatic disease versus a neural sheath tumor/schwannoma.”

Hopefully, the next ct scan will reveal further shrinkage.
Meanwhile, I have been rather busy with speaking engagements and working on my next book. I will be heading for Israel on March 20 for a month, then it’s on to Limmud Philadelphia at the end of April and a rather busy speaking schedule in May and June. And, of course, more Tarceva.
Again, I would like to thank everyone for their kind wishes and prayers on my behalf.

Gil