Peeling Back the Layers of Cancer
The Biopsy – Finding the Source
A biopsy is the only way to confirm where cancer originates. This procedure involves removing a small tissue sample from the tumor to examine under a microscope. The goal is to determine whether the cancer cells resemble those of the colon, liver, lungs, or another organ.
For Amit, the biopsy confirmed that his cancer originated in the colon but had already spread to his liver, bones, and lungs. At stage 4, this meant a cure was unlikely, but treatment could extend life and improve quality of living.
Genetic Testing – The Key to Personalized Treatment
After the biopsy confirmed colon cancer, the next step was genetic testing. Cancer is no longer treated the same way for everyone. Genetic mutations determine which treatments will work best.
For Amit, these were the key findings:
Microsatellite Stability (MMR Status)
- Amit was MMR proficient (Mismatch Repair Proficient), meaning his cancer would not respond to immunotherapy.
- Immunotherapy works best for MMR-deficient (MSI-high) cancers, but Amit’s cancer did not have this characteristic.
Tumor Mutation Burden (TMB)
- Tumor mutation burden measures how many genetic changes exist in the tumor. A higher mutation count often means immunotherapy will work better.
- Amit had a low tumor burden, meaning his cancer was unlikely to respond to immunotherapy.
KRAS G12D Mutation – A Tough Roadblock
- Amit’s cancer had a KRAS G12D mutation, a highly aggressive and difficult-to-treat mutation.
- Many modern targeted therapies (like HER2 or BRAF inhibitors) were not options for him.
- KRAS mutations currently have no effective targeted treatment, though research is ongoing.
With immunotherapy and targeted therapy ruled out, our only option was chemotherapy—a traditional, but harsh, approach that attacks all rapidly growing cells in the body.
Fighting Cancer With Every Possible Tool
Amit underwent multiple chemotherapy regimens, each with different combinations of drugs. None of them shrank his tumors, but they prevented new tumor growth, which was the only victory we had in this entire journey - gave us those 351 days with him!
FOLFIRI – The First Battle Plan
FOLFIRI is a combination of three chemotherapy drugs:
- FOL – Folinic Acid (Leucovorin) to enhance effectiveness
- F – Fluorouracil (5-FU), a drug that blocks cancer cell growth
- IRI – Irinotecan, which prevents cancer cells from repairing themselves
FOLFIRI was Amit’s first-line treatment, meaning it was the initial chemo doctors believed would work best.
FOLFOXFIRI – The Strongest Weapon
FOLFOXFIRI – The Strongest Weapon
In an attempt to hit the cancer harder, doctors combined FOLFOX and FOLFIRI into one regimen, known as FOLFOXFIRI. This was one of the strongest chemotherapy combinations used for colon cancer, designed for patients who could handle aggressive treatment.
- It combined Oxaliplatin (from FOLFOX) and Irinotecan (from FOLFIRI)
- It was the last major chemo option available
Despite the toxicity, Amit powered through, refusing to give up.
Lonsurf – The Last Resort
When all traditional chemo stopped working, doctors prescribed Lonsurf (Trifluridine/Tipiracil), an oral chemotherapy drug used for patients who have exhausted other treatments.
- Lonsurf doesn’t shrink tumors, but it helps slow down cancer growth and extend life.
- It comes with brutal fatigue, nausea, and digestive side effects, but Amit took it anyway.
Through 23 chemo cycles and 21 radiation sessions, Amit’s tumors never shrank—but they also didn’t grow, which meant we were able to slow the disease for as long as possible.
Lessons I learnt from the journey
Lessons I learnt from the journey
- Cancer is not one disease—it’s thousands of different battles.
- Early detection is everything. Colon cancer screenings now start at 45. Get checked.
- U.S. doctors are great at treatment but slow at diagnosis. Push for answers.
- Clinical trials take time. If you need one, start early and be aggressive.
- Nurses are the unsung heroes—they do more for patients than doctors ever will.
- Listen to your body. Pain, weight loss, and extreme fatigue are red flags.
- Cancer research is advancing. The battle against KRAS mutations is just beginning.
Final Thoughts
Final Thoughts
Amit fought cancer for 351 days—not just for himself, but for all of us who loved him. He endured pain beyond words and never gave up hope.
Though cancer took his body, it never took his spirit. His fight has changed me forever, and I hope his story helps others facing their own battles.
Keep fighting.
Keep hoping.
Never give up!