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Rower Michelle

Starting Alectinib today

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Hi and good morning.  This afternoon I have a chemo teaching appointment with the nurse practitioner before starting Alectinib today.  Do you have any insight as to what I need to be looking when starting the treatment?  Common side effects and how to manage them?  Thanks very much.  I appreciate any information! 

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Hi, Michelle,

I’ll reach out to some of our members who have experience with ALK targeted therapies and ask them to respond in this thread. Thinking of you today!

With gratitude,

Lauren

Digital Community Manager
LUNGevity Foundation

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Lauren- thanks for the outreach.  I did send a request to the ALK Facebook page as well.  I had to set up a FB account, I'm probably the last person in the country not to have a FB page. Unfortunately, FB disabled the account as "suspicious" activity.  I filed an "appeal" explanation to explain yes, I'm a real person.  Bizarre.   

Mary- I hope your husband does well on the treatment.  Please keep us posted! 

I went  on Friday for my chemo teaching.  The nurse practitioner told me I'm the first patient she's had on the Alectinib. So we will be trailblazers together.  Thanks to Dr. Google, I knew as much as the ARPN.   Alectinib needs to be taken with meals  high fat, high calorie to enhance the absorption.  (Good grief, I see a heart attack coming!!)      "Absorption increased active metabloite M4 by 3.1 fold"  (Greek to me but I will track the translation down). 

Here is the monitoring protocol from Wolters Kluwer the nurse downloaded for me. 

Monitoring Parameters: 

Liver function tests (ALT, AST total bilirubin) every 2 weeks during the first 3 months of therapy, then monthly as clinically necessary (monitor more frequently in patients who develop transaminase and bilirubin elevations; CPK levels every 2 weeks for the first month of therapy then as clinically necessary; monitor heart rate and blood pressure regularly, monitor for signs and symptoms of interstitial lung disease/pneumonitis and myalgia. 

 

Monday I have a baseline CT and Tuesday is the Integrative MD appointment.   I will ask about the best food for absorption and pass along the information. 

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Great that you're getting all that info--and I'm sure that sharing here what you will learn will be helpful to those folks who will be prescribed this drug in the future.

So "comfort food" is actually part of the plan!  :) 

Keep us posted--I love learning about this stuff. 

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There ya go--I'm not a native Jersey Girl (from Colorado originally) but I've been here since 1981.  But I'm in South Jersey, which really might as well be another state, lol.  I'm right across the river from Philly (Camden County).  

I definitely think living here has toughened me up.  :)

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Hi Lauren, 

Thanks for checking in.  It's been a miserable week with a trip to the ED on Monday night (evidently fevers don't operate on a 9-5 schedule).  The ED was able to rule out anything nefarious and would seem this is a pesky virus.   Here's the best thing that came out of the trip!  A CT Scan was done to rule out a pulmonary embolism.   They were able to compare the CT to the first one I had in September when initially diagnosed and there's been IMPROVEMENT in the lymph glands noted!!  

I didn't need a scan to tell me the meds are working.  I took the first dose of Alectinib on Friday, October 26th.  That night, the violent coughing fits miraculously stopped.  For the first time in six weeks I was able to sleep through the night!   So far no more violent coughing fits have occurred since then.   The port catheter was removed last week and I'm finally rid of that little bugger.  It was eroding through the skin (from the coughing fits) and will take a few more weeks for the surgical site to heal completely.   Maybe I'll be able to get back on the rowing machine before Christmas. 

I'm being detoxed off that dreadful codeine cough syrup.  Four more days to the final dose.  So glad to be detoxing so I can have a glass of wine with Thanksgiving dinner!  

Today was my first set of labs.  Generally tolerating Alectinib well.  My platelets were a little low (102) and will be redrawn next week.  I've got some mild edema, but it's nothing compared to what I've been through recently.   I will return to the Integrative Medicine doc on Tuesday to review  a treatment plan- which I'm really looking forward to. 

It's hard to believe it's only been seven weeks since I've been diagnosed with lung cancer.  I still have trouble getting my head wrapped around it on some days.  The first three weeks were an emotional roller coaster.   Now with treatment underway, I feel battle ready for this.  It's great to have this forum to see the fighting spirit of survivors.  

Appreciate having the support of this community! 

Michelle 

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