CHEMO 101 - long but perhaps interesting

Here is a quick rundown on Lauren's chemo. Chemo is basically a set of drugs given through IV that are supposed to kill all the bad cells in your body while still trying to keep a few of the good cells in tact. The treatment plan varies depending on the drugs used. In 2006 when she had chemo, the infusions were 2 different meds for a few hours every 10 days. This time there are 5 drugs which are infused over 5 days. She got the first 2 on Friday. (Vincristine and velcade) The third - called methotrexate then began. This has to be followed by continuous fluid infusions to get it through your system. After about 72 hours, the blood test they take indicated that the fluids can stop. Then she gets a 4th drug - cytoxan for 6 doses, 12 hours apart. After each of those she has to get fluids with certain electrolytes in them for 12 hours. The 5th drug is prednisone - oral pills at a high dosage for 5 days. So, that is why each round is a 5 day admission. The 2nd drug she get again on day 4, 8 and 11, but that is about a 15 minute infusion with no need for fluids to follow so that can be given outpatient.

At about day 7, her white count drops really low, she gets a shot in her arm, and then the white count is supposed to go back up gradually. All of these meds have various side effects, the worst of which is nausea and bone pain, so we give her meds to try to lessen those side effects. During all of these infusions of fluids, her electrolytes can get wacky. Potassium and magnesium are particularly important to good heart function, so we watch those closely and adjust meds as needed.

Some have asked me if the chemo hurts. No, she can't really feel it going in - just the side effects are bad. The pain in her abdomen has been gone for several weeks, so she can't really tell if the cancer is disappearing either. These "rounds" of chemo are supposed to be about 21 days apart. Just enough time for the body to be strong enough for the chemo again, but not long enough for the bad cells to have time to start multiplying again.

I have also been asked about radiation vs chemo. Radiation is done by x-ray type machines and targets specific spots in your body. Some cancers respond to this rather than chemo. She isn't using radiation with this cancer. I have also been asked what her "plan" is. With leukemia and some other cancers, there is a long-term, many month protocol in place. Scanning and testing is done every 3-4 treatments to check progress. With Lauren, because of all the variables, it isn't such a cut and dry plan. We did a CT scan, then a PET scan, then round 1. After round 1, another CT showed shrinkage but the oncologist didn't want to continue a few of the drugs because of their side effects, especially on the heart. So, round 2 was a different recipe which we have done this round as well. Lauren did have a PET scan on Wed and the initial read shows some improvement. However, it is a holiday weekend, so official results won't come until at least Tuesday.So, we arrived on Friday to begin this 3rd round. Lauren had looked like this and felt great since Monday, but once these drugs began, she has been sleeping quite a bit. The nausea is worse this time around, so she takes Kytril and Phenergan which both knock her out. As for Blair and I, our system seems to work. I can only last 3 nights here before I need my own bed, a shower that I don't have to wait in line to use, and to interract with my other kids. By that time, Lauren and I have had enough of each other and she needs Blair for comic relief!! I do a few loads of laundry, get some exercise, run to the grocery store (they don't eat vegies in my absence), review the happenings of the kids, organize who is picking up who at what time the next few days I am gone, go through the mail, repack some clothes and leave again.