Going strong – Mahendra Modi

We catch up with lung cancer patient, Mahendra Modi (79), who was on our Nov/Dec cover, in 2016, and hear how well he is doing on osimertinib (Tagrisso), an oral medication.

Mahendra Modi (79) lives in Mulbarton, Gauteng with his wife. He has three children and seven grandchildren.

Background

Mahendra was diagnosed, in 2014, with Stage 4 lung cancer associated with an EGFR mutation. This type of lung cancer is not related to cigarette smoking but is driven by a mutation (changing of the structure of a gene), called an EGRF mutation. 

Due to the stage of Mahendra’s cancer, surgery was not an option as Stage 4 is not curable/treatable with surgery. Though, he was prescribed erlotinib (Tarceva), an oral tablet that he took daily. The grandfather did well on this medication for over two years. The cancer nodules reduced in size, and by April 2015, the nodules were almost gone.

However, in June 2016, the cancer nodules in Mahendra’s lung shifted and grew. The cancer had developed resistance to the drug, Tarceva. The resistance pattern was another mutation developing, T790M mutation. 

Due to this new mutation, Mahendra was eligible for another oral drug, osimertinib (Tagrisso). Though, due to this drug not being available in South Africa, his oncologist applied for him to be on a compassionate program, which was granted by the South African Health Products Regulatory Authority, under the Section 21 regulation.

In December 2016, Mahendra started taking Tagrisso every day. This program allowed him access to life-saving medication for free thus enabling him a good quality of life and ongoing survival.

Radiation

Unfortunately, in October 2017, the cancer started growing again. 

The treatment choice was between chemotherapy and radiation. In the end, 16 sessions of 15-minute external beam radiation was decided on, with the continuation of Tagrisso.

The radiation oncologist informed the grandfather of the side effects he could suffer: rash, burn marks, diarrhoea and mouth sores, etc. She advised him to use Dove soap, which is fragrance-free, especially on the part of the body where he would be radiated.

As usual, Mahendra complied with his doctor’s instruction and faced radiation with a calm head. The results were good, with the cancer shrinking. “They confirmed that the specs were scar tissue and not cancer,” Mahendra adds. 

Minor health complications

Since then, Mahendra has had a few health complications, regarding his thyroid, kidneys, liver and sodium intake. But, the concerns normalised after a change in his blood pressure and antihistamine medication, as well as him adding extra salt to his diet. 

Another complication was when an antibiotic, that was prescribed for flu, caused some havoc in his body that made his medical oncologist worry. A CT scan was done. All was clear and it was concluded that Mahendra should not take that antibiotic again. 

Current health standing

The 79-year-old is doing well. “The main thing is that I never panicked or thought of the worst outcome,” he says.

The lung cancer patient continues with his diet plan, which excludes meat, chicken, and sugar, and he keeps active by playing lawn bowls at club level, three times a week and by going to the gym.

He adds that he has had milder side effects on Tagrisso, such as a mild rash, his nails being sore and numb, diarrhoea, fatigue, and loss of appetite. “But, I never stopped taking the medication and won’t unless my oncologist instructs me to,” Mahendra says. 

He carries on with his life like normal, visiting his son in Australia, and still doing his PR community work for the Annual Gandhi Walk.

Blood tests have become a regular, while every four months a CT scan is done. 

Mahendra’s advice for cancer patients

• Never ask why me? Just accept it. This is hard but turns out to be the easy way to process the diagnosis.
• Stay positive and calm – comply with your doctor’s instructions and medication prescribed. 
• You must have full confidence in your doctor and be honest with her/him.
• Take control of your diet, you must care for your body and its needs. 
•  Keep your immune system up. 
• You must fight for your own recovery. No one else can. Side effects will come but you can’t let that deter you.

Tagrisso now available in SA

May this year, Tagrisso was registered for use in South Africa and is now available. It is still not clear whether medical aid  schemes will cover the cost of Tagrisso treatment.

What is Tagrisso? 

By Dr Sze Wai Chan

Tagrisso (osimertinib) is a third-generation tyrosine kinase inhibitor (TKI) for use in Stage 4 EGFR mutation-positive lung cancer. 

It was designed initially to overcome an acquired resistant mutation, T790M, which developes in approximately 60% of patients receiving the first- or second-generation TKI, such as erlotinib (Tarceva).

At present, Tagrisso is indicated for use in patients who progressed on first-generation TKI (erlotinib), and whose tumour has developed the T790M mutation. This acquired T790M mutation must be detected on blood or repeated tumour biopsy.

Tagrisso is also indicated in the first-line use in stage IV EGFR mutation lung cancer, which has been shown to improve survival, versus first-generation TKI. 

The drug, Tagrisso, has the advantage of better brain penetration, and less skin and gastro-intestinal side effects.

MEET OUR EDITOR  – Laurelle Williams

Laurelle is the Editor at Word for Word Media and graduated from AFDA with a Bachelor of Arts Honours degree in Live Performance. She have a love for storytelling and sharing emotions through the power of words. Her aim is to educate, encourage and most of all show there is always hope. Write me: [email protected]