Treatment Decision Making in RCC: Patient and Caregiver Perspectives
A brief discussion elucidating the patient and caregiver perspectives when selecting a treatment option for renal cell carcinoma.
Transcript:
Hans Hammers, MD, PhD: Terri and Kaitlin, the start of this treatment was not the conventional pathway of coming into our office. It was a little bit more chaotic obviously and we decided to treat you with one of the pills called lenvatinib [Lenvima] and the immunotherapy was pembrolizumab [Keytruda]. When you heard some of these side effects that we discussed, what were some of your concerns when you heard that? What was your initial thinking? Were you afraid that you were hurting her too much or things of that nature?
Kaitlin Blalock, NP: Originally, when she was diagnosed, I was like we need to hurry up and get her treatment quickly. Then, after hearing the side effects and the possible complications, it does make you pull back a little bit and feel kind of overwhelmed. It was important that I knew as a caregiver and her being slightly confused that I needed to make sure that the side effects, if they happened, that we would make sure that we reported them in a timely manner because I knew that she was not able to at that point. I also knew that if we did nothing, then ultimately, she would be dead. At that point, I was just trying to hurry up to get the pill and get the immunotherapy going, so that we stood a chance of helping her improve. I never imagined that she would be where she’s at today. Once again, kind of living by herself and able to care for herself. She can bathe herself, get her own food again, and she’s no longer oxygen dependent. The medication did help tremendously.
Hans Hammers, MD, PhD: I’m just curious about sometimes when someone is diagnosed with advanced cancer, the thought also comes up, do we want to do all of this, or should we just focus on comfort and things of that nature? Did that ever cross your mind?
Kaitlin Blalock, NP: It did cross my mind. But my grandmother pretty much raised me and I was not ready to let her go. For selfish reasons, I was pushing her to seek treatment and I did sit down and have a conversation with her. Grandma, I don’t know if you remember or not, but we discussed, do you want treatment, or do you want me to call hospice and we can go home and keep you comfortable. You said, “No. I still want to live. I still want to try this. I want to fight this.” When she told me that, I was like, we’re doing this because half of the battle is the mentality that you have in this fight.
Hans Hammers, MD, PhD: Absolutely. And I can see that this can be a challenge for a lot of families, but that’s the promise that we have now in kidney cancer that even if somebody presents with dramatic initial presentations we have initially at least very effective therapies that can have a huge impact on patient outcome and survival in 2022 when you started and now in 2023. I’m very glad that you’re doing well.
Transcript edited for clarity.
Hereditary Renal Tumor Syndromes and the Use of mTOR Inhibitors
A 47-year-old woman with a history of drug-resistant epilepsy during childhood presented to the emergency department with sudden dyspnea and chest pain. Upon admission, her oxygen saturation was 88%.
