New Treatment Plans
When any doctor has walked into the room and told me “I have good news and bad news,” the bad news has been pretty bad and the good news is merely to make the bad news not as difficult to relay to the patient. This was the case today when I saw my oncologist.
The “good news” was that the puss/mucus that the pulmonary doctor removed during my bronchoscopy yesterday opened up the clogged airway in my lung and inserting a stint is no longer necessary. My doctor feared that it was tumor that was clogging it and therefore that was the urgency for possibly doing radiation to that area. Radiation would produce immediate results and that’s why it was considered. I still haven’t received the results of the samples of tissue/cells that were taken during the procedure, but my doctor is sure they contain cancer cells due to the results of the PET. Due to the results of the PET, radiation is no longer an option for treatment at this point.
The “bad news” is that the PET/CT that I had done on Monday confirmed that not only did my new lung mass grow, but the main mediastinal mass in my chest is now growing once again. This of course was the most devastating news. It appears as though the radiation that I had done back in May to that area has finished doing its job and is no longer keeping my disease under control. We knew it would be a matter of time before this would happen, I just didn’t expect it to be so fast.
With all the new information from the last two days my doctor met with the usual Lymphoma experts as well as my BMT doctor to come up with a new treatment. I’ve been so fortunate the last year and a half having had such easy treatments. The side effects were pretty minimal and I was able to maintain a semi-normal life, including going back to work. My doctor has always taken these factors into consideration when coming up with treatments for me. Unfortunately this time, that won’t be the case.
The new chemo that I will be starting will require me to be inpatient. The drug is called Methotrexate and it will be given in combination with another drug called Leucovorin. The reason I have to receive this inpatient is because first I have to be given plenty of fluids (which I hate) due to the toxicity to the kidneys. They will also have to monitor my levels of the chemo in my body closely the first couple of days. 24 hours after administering the chemo they will start the Leucovorin, which will kill off the effects of the chemo. The way this chemo works, is that it attacks the tumor cells within the first few hours and then after that it goes for the good cells. The Leucovorin will help eliminate/reduce the chemo from killing my good cells, therefore not affecting my counts so much and reducing the side effects from the chemo. Since this is a high dose chemo, the side effects could otherwise be pretty bad/intolerable. They will check my blood daily to see the level of toxicity in me and once it’s at a safe level they will let me go home. This could be anywhere from 3-5 days the first time. After that, if all goes well, the hope is to have me be inpatient for 2-3 days and send me home on an oral version of the Leucovorin. I would still have to go in daily for blood tests, but not have to stay inpatient as long. The treatments would be given every other week, so just when I’m starting to recover I will be admitted again for the next round.
I will be admitted for my first treatment this coming Sunday morning. If all goes well I could be discharged on Wednesday. They're hoping to get my 2nd treatment in right before Christmas (12/19), but there are no guarantees.
I usually don’t complain about chemo or let new treatments bother me, I simply go with the flow, but this one is really upsetting to me. This will definitely impact my work and quality of life. Stanford will once again become my second home as it did with my two transplants. The likelihood of having my own room will be small since I won’t be neutropenic at the time of admission and that means Chris may or may not be able to stay with me overnight. Of course having to start all of this during the upcoming holidays is even more depressing. I know I should be grateful that I still have options available and that my oncologist has put so much thought into the best possible treatment considering the circumstances, but I just feel this is really starting to take over my life.
The “good news” was that the puss/mucus that the pulmonary doctor removed during my bronchoscopy yesterday opened up the clogged airway in my lung and inserting a stint is no longer necessary. My doctor feared that it was tumor that was clogging it and therefore that was the urgency for possibly doing radiation to that area. Radiation would produce immediate results and that’s why it was considered. I still haven’t received the results of the samples of tissue/cells that were taken during the procedure, but my doctor is sure they contain cancer cells due to the results of the PET. Due to the results of the PET, radiation is no longer an option for treatment at this point.
The “bad news” is that the PET/CT that I had done on Monday confirmed that not only did my new lung mass grow, but the main mediastinal mass in my chest is now growing once again. This of course was the most devastating news. It appears as though the radiation that I had done back in May to that area has finished doing its job and is no longer keeping my disease under control. We knew it would be a matter of time before this would happen, I just didn’t expect it to be so fast.
With all the new information from the last two days my doctor met with the usual Lymphoma experts as well as my BMT doctor to come up with a new treatment. I’ve been so fortunate the last year and a half having had such easy treatments. The side effects were pretty minimal and I was able to maintain a semi-normal life, including going back to work. My doctor has always taken these factors into consideration when coming up with treatments for me. Unfortunately this time, that won’t be the case.
The new chemo that I will be starting will require me to be inpatient. The drug is called Methotrexate and it will be given in combination with another drug called Leucovorin. The reason I have to receive this inpatient is because first I have to be given plenty of fluids (which I hate) due to the toxicity to the kidneys. They will also have to monitor my levels of the chemo in my body closely the first couple of days. 24 hours after administering the chemo they will start the Leucovorin, which will kill off the effects of the chemo. The way this chemo works, is that it attacks the tumor cells within the first few hours and then after that it goes for the good cells. The Leucovorin will help eliminate/reduce the chemo from killing my good cells, therefore not affecting my counts so much and reducing the side effects from the chemo. Since this is a high dose chemo, the side effects could otherwise be pretty bad/intolerable. They will check my blood daily to see the level of toxicity in me and once it’s at a safe level they will let me go home. This could be anywhere from 3-5 days the first time. After that, if all goes well, the hope is to have me be inpatient for 2-3 days and send me home on an oral version of the Leucovorin. I would still have to go in daily for blood tests, but not have to stay inpatient as long. The treatments would be given every other week, so just when I’m starting to recover I will be admitted again for the next round.
I will be admitted for my first treatment this coming Sunday morning. If all goes well I could be discharged on Wednesday. They're hoping to get my 2nd treatment in right before Christmas (12/19), but there are no guarantees.
I usually don’t complain about chemo or let new treatments bother me, I simply go with the flow, but this one is really upsetting to me. This will definitely impact my work and quality of life. Stanford will once again become my second home as it did with my two transplants. The likelihood of having my own room will be small since I won’t be neutropenic at the time of admission and that means Chris may or may not be able to stay with me overnight. Of course having to start all of this during the upcoming holidays is even more depressing. I know I should be grateful that I still have options available and that my oncologist has put so much thought into the best possible treatment considering the circumstances, but I just feel this is really starting to take over my life.
posted by Erika @ 9:49 PM
1 Comments:
At 8:08 AM,
Anonymous said…
Erika and Chris: My heart, love and prayers will go into overtime for you, in your upcoming weeks. It was sooo very good to see you at Nike, and to see your two (four!?!) smiling faces!! Many, many hugs to you both, and please keep my number handy if I can do anything at all. Anything.
Much love,
Janna
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