My Liver Cancer Blog

At our most recent meeting with my oncologist we learned that some results have come back regarding the genomic analysis of the biopsy material from my tumor. As I mentioned in an earlier post, a tumor’s growth is often driven by a specific mutation, and for some of the more common mutations, there are specific drugs. These drugs work in a variety of ways — for example, they can prevent the production of the enzymes that enable the tumor cells to replicate. (Below are the common mutations and the relevant drugs).

I was a little bummed to learn my tumor doesn’t have the FGFR2 mutation because there are 3 or 4 drugs for that one. But I was happy to learn that it does have the IDH1/2 mutation, for which there is the drug ivosidenib (brand name Tibsovo).

I was also reading online that a tumor can have more than one mutation, and that sometimes these mutations are in different locations. So one mutation is driving growth over here, while a different mutation is driving growth over there. I’ll admit this kind of freaks me out. On the one hand, more mutations might mean more possible targeted therapies; on the other hand, it might mean that one drug will work at one part of the tumor, but not a different part.

In any case, at least my tumor has at least one mutation for which there is a drug. 50% of patients do not. I won’t be starting on this drug immediately. I think this is a “let’s keep it in the back pocket for when we really need it” kind of situation.

I also just want to say that I am fine. (I realize that when I don’t post for a while some people worry). I had a stretch of 3 or 4 days when I literally lay on the couch and napped most of the time. But then one morning I woke up feeling AWAKE, and I had a wonderful stretch of 3 high-energy days. It is a profound relief to me that the exhaustion I was feeling was short-lived.

I talked about it with my therapist, and she said it could be chemo side effects, but could also be grief. And I suppose that’s possible. I haven’t consciously been experiencing grief recently — for the loss of what still feels like “my real life,” for the loss of the long future I probably won’t have, for my loss of energy and strength, for all the beautiful hikes I probably won’t do, for the likelihood that I won’t be able to see who my niece becomes as a grownup. So, I haven’t been feeling it, but all the griefs immediately come to mind without effort. And sometimes I’ll be hugging my husband before bed at night and I’ll think, “Boy am I going to miss hugging him when I’m dead.” (Sorry, honey, I think that last sentence will make you laugh and cry).

So yes, maybe the fatigue is a way of experiencing that subconscious grief, or a way of processing it without really having to process it. But I’m happy not to feel it. Now is not the time for feeling grief. Now is the time for walks in fall weather, laughing with my sister, doing whatever I can to shrink this damned tumor, enjoying the delicious dinners made by my husband, and maybe, just maybe, planning a hiking vacation with some friends in the spring.