More than 15 years later a clinical trial uncovered a whisper of hope for pancreatic cancer patients the world over. The trial combined the drug Abraxane with Gemzar and the results showed a marked improvement in the survival rate for these patients. Not a cure, mind you, but improvement in treatment nonetheless. In this hardscrabble fight to the finish, every day, every week is an inch we'll take and not give back...
On September 6, 2013, the FDA approved this combination of Abraxane with Gemzar as the first-line treatment for advanced, metastatic pancreatic cancer. Mom had been gone already nigh on 2 years. But we know, we know, how she would have applauded this small victory. Anything that can hold back the advance of the cancer gives us a chance to hang on for the cure. And time to love and live and smile and hope...
So, what exactly is Abraxane and how might it fit into your treatment plan?
Time for some research...This is what I found out about the new kid on the block.
Abraxane is the brand name for a drug called Paclitaxel.
Abraxane belongs to a class of chemotherapy drugs called plant alkaloids. Plant alkaloids are made from plants. There are many types of plant aklaloids. Abraxane belongs to the group called taxanes. They are made from the bark of the Pacific Yew tree (taxus). They are also known as antimicrotubule agents.
Antimicrotubule agents (such as paclitaxel), inhibit the microtubule structures within the cell. Microtubules are part of the cell's apparatus for dividing and replicating itself. Inhibition of these structures ultimately results in cell death.
Abraxane is a "re-packaged" chemo drug that many might have heard about from the breast cancer war. It started as the drug Taxol (paclitaxel). Many breast cancer patients have been and are still on this drug. The problem with Taxol is that it doesn't dissolve in water, so in order to give it to patients it has to be mixed with a harsh solvent that often caused a huge number of side effects, including severe allergic reactions.
Enter the Abraxane solution. Scientists developed a process that bound the Taxol (paclitaxel) to a naturally occurring protein called albumin, making a little package that easily dissolves in water. The exciting part about this process is that patients receiving the newly packaged Abraxane had better results than using the old Taxol. Because albumin, which normally transports nutrients to cells, accumulates in rapidly growing tumors, it's possible that the bundles of Abraxane in their albumin "envelopes" are sent by express delivery directly to cancer cells. Targeted chemotherapy.
Ok, that's all the medical jargon. In simple English, Abraxane goes after the cancer cells that are busy growing bigger and bigger. Abraxane sneaks right in, hitching a ride with his protein friend and hi-jacks the cancer cell from the inside out, just like a crafty Trojan Horse, seeking to win the battle with stealth and cunning.
Of course, Gemzar is busy taking care of the cancer cells too... So combining the two chemotherapy drugs is a double-whammy on the cancer. It's also a double-whammy on the side effects.
Along with Gemzar's flu-like malaise, fatigue and low blood counts, you might also experience the common side effects of Abraxane:
Hair Loss
Nausea
Peripheral Neuropathy (numbness/tingling in hands and feet)
Mouth Sores
Swelling of feet or ankles
Pain in joints and muscles
Abnormal ECG
Infection
Eye Problems
Low Blood Counts
Weakness and Fatigue
To be fair, most cancer patients don't experience ALL of the side effects. But trust the patients who've been there, even just one or two of the side effects is enough to knock you to the sidelines... And you might have noticed that low blood counts and fatigue are side effects for both drugs. Pretty good bet that you will experience these two for sure...
One of the ironic things about this cancer journey, especially right now as I am writing about the newest chemo protocol for pancreatic cancer, is that my Aunt Emily actually was on Abraxane for her metasticized breast cancer. She and mom both walked their cancer roads about the same time frame, although Aunt Emily's cancer began many years before mom's. And what's even more ironic is that she and my mom wrote back and forth regularly and mom kept those notes, complete with so much of their thoughts and experiences with cancer. She never lived to see the day that the Abraxane might have helped stall her pancreatic cancer, even though she cheered it on for Aunt Emily, praying it would turn the tide of her cancer.
It is both heartbreaking and humbling to read their sweet encouragements to one another. I am beyond thankful to have these treasured words, a sharing of their hearts.
And in a way of giving still, Aunt Emily shared with mom short bits and pieces of her dealings with chemo... I have pulled some of her notes thru the months that pertain to the Abraxane to share with you. Not a journal really, but a small peek into life with chemo...
The taxanes are just rough on me. The Taxol I had in 2003 permanently damaged my feet, which was the one main residual effect from the first time around.
* * * * *
If I'm written up in the medical journals, it may be for complaining about the new chemo I'm on (Abraxane). It's really hitting me pretty hard with fatigue and neuropathy. At least it's making more things hurt. I need to talk to the doctor about pain options. I was hoping that at this point in the cycle it would be much better. It is better, but my back and affected hip and leg aren't really (her cancer had metasticized to her bones at this point). Also, all my hair is gone. I simply lifted it off my head in clumps as all the follicles had released. At least I'm not shedding on anything anymore.
* * * * *
The good news for me this week was that the cancer marker had reversed direction, and was down four points. The doctor said twice that indicated stability for the moment. This new drug (Abraxane) is nasty, though. The first cycle I felt lousy for a whole week of the three. This time, I wasn't bad the
few hours after the treatment on Wednesday but then ran a fever close to 101 for 24 hours plus and had a lot more nerve pain. I was feeling better by Friday afternoon but then kind of got zapped again yesterday. The hip pain and pain in that leg are more of a problem and there's general neuropathy with this. I'm realizing that the Xeloda heyday is over. These last two drugs (Abraxane and another chemo drug called Ixabepilone) are simply going to take more of a toll and after that it will be hospice. I'm hoping to continue to be productive, though know it won't be for as many hours. At least this new drug doesn't make me excessively emotional and give me that plaguing olfactory phenomenon.
* * * * *
The marker dropped a couple of points after three weeks, so I had another infusion of the same chemo, but on a three week cycle so it's harder. I'm losing stamina and I'm having trouble with my eyes--holes in my vision and flashing lights.
* * * * *
The other thing--I was realizing at 3 a.m. that, in the 32 months since I knew something was wrong with me (Aunt Emily's metastases to the bones were misdiagnosed for months before a perceptive doctor finally picked up on her breast cancer diagnosis from 5 years earlier), I've had close to a year with no treatment or ineffective treatment, 17 months on Xeloda that worked, maybe three and half months split between Abraxane and Navelbine when they worked. I've had three treatments that didn't work at all--Faslodex (a hormone therapy), Gemzar, and Eribulin. And I don't know if this Ixabepilone is working or not. It sort of startled me thinking of it all that way. Without Abraxane as a stopper and the Xeloda, there really wouldn't have been much of anything but the disease working its course. --L, E.
* * * * *
Aunt Emily had Abraxane pegged perfectly... Abraxane is a stopper of cancer cells...for a time. And for those pancreatic cancer patients using the combination of Abraxane with Gemzar it is our daily pray for the treatment to stop all cancer growth for as long as possible.
Wishful thinking? Perhaps... And the side effects can be brutal... Truly. But the gift is time. In this fight each patient has such an impossible decision to make. Time, but at what cost? Only the cancer patient can make that decision...
Praying for wisdom and peace in abundance as we journey this road... In Grace, Always,
Jane
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