Half Full? Half Empty?

I suppose that one might think, reading this blog, that I'm pretty optimistic about my disease state and what my future holds. I have to say that I'm optimistic to a point, but a heavy realist -

Metastatic renal cell carcinoma is now something that is considered a "chronic condition", rather than an immediate death sentence. It is, nonetheless, a death sentence of sorts - as one doctor wryly put it, "We consider you cured of RCC when you die of something else." At least now, through the wonders of science and new drug development, there is a chance for one to achieve stable disease status for some indeterminate length of time. The bell curve now goes far further to the right than it used to, and this has happened in just the last few years.

What's uncertain now is whether longevity can be measured in years rather than months or weeks - initial studies of Nexavar show an overall trend toward stable disease status in the 48-week range, for example. The cheerful news is that the studies haven't been able to be closed in many cases because the trial subjects are still living, so there isn't an endpoint.

Cancer is an amazing organism, though - we may generally expect that it will mutate itself to negate the drug-of-choice's effectiveness over time. That mutation will be seen on an individual level, of course, as one's own body determines how the cancer will progress, how effective the drugs are, and what side effects one might have.

So, in my case, while Nexavar is working now, there will come a time when it doesn't, when the cancer outsmarts the drug. Tune in next week, as the old radio series used to say - or next month - or next year, whatever. In the meantime: Hey, waiter, my glass is half-full. Can you top it up?