Wednesday, October 28, 2009

Induction Treatment, Day 7: Last Day of Chemo (for now) and Some Good News

Well, this has been interesting. I expected to be wiped out, barely able to get around, nauseous all the time or worse. The types of chemo I've received don't really make me too sick, and I haven't needed any transfusions so far. The real side effects come with the crashing of my blood counts - the risks of infections, bleeding and fevers. I just started having some weird complications, such as jaw pain, heartburn and a nail infection. At most, I only need the anti-nausea medication once a day. I haven't lost my hair yet, but that should happen any day now. Later this afternoon I will start my last of this 7 day 24/7 infusion of Cytarabine, or Ara-C. Then I think I will get a break. My counts will continue to drop, and then slowly I will re-build my bone marrow. Once that happens, I'll have another bone marrow biopsy to see if I need more treatment.

Once I enter what's called Complete Remission, I may get a longer break before entering the Consolidation Phase. Consolidation is necessary to provide more therapy to eliminate non-detectable disease and prevent relapse — that is, achieve a cure. Typically, this means high doses of Ara-C for 3 of 5 days, once a month for 4-6 months, depending on my blood levels. I thought at first that this current 6 weeks of Induction would be the end of the chemo story, but this is only the first half of the equation. How I'll feel and how much I'll be able to do during Consolidation remains to be seen. All I care about right now is going into remission and getting well enough to go home to my kitty!

Dr. Forte called my room the other night and was very excited to deliver good news. There are subtypes of Acute Myeloid Leukemia, (AML), from M0-M7, and these subtypes have very different treatments and prognoses. I learned that I have M4 eos, which is much better than the more common M4. And he told me that I have a really cool chromosomal abnormality. Here's the lowdown:

The most important factor for predicting a prognosis is cytogenetics, or the chromosomal structure of the leukemic cell. Certain cytogenetic abnormalities are associated with very good outcomes, one of which is called inversion 16, or inv(16). This means that one of the genes on chromosome #16 is flipped. This is good because it's easy to detect and once it's found, I can get treatment before things go downhill. The upshot is that this wacky chromosome significantly increases my chances of long term survival and reduces my chances of a relapse.

Dr. Forte is also researching the possibility of other treatments that will further reduce my chances of a relapse. Even with a Complete Molecular Remission (the best kind of Complete Remission), some hidden cancer cells can still exist. Of course he doesn't want me to have anything that I don't need, and neither do I. But he is talking with a bunch of other doctors to come up with the best plan for me to be around long enough to die of something other than stupid cancer!

Today I read a new post in my favorite resource for anti-cancer prevention and general health, Anticancer, by Dr. David Servan-Schreiber, called Getting by with a little help from our friends. If these findings are true, I'm on my way to being the healthiest person I know, thanks to all of you who have helped in countless ways already!



1 comment:

  1. Kathy,
    I'm sorry that I have not written sooner. Kathleen got married on Sat. and we were busy before and after the wedding.
    Glad to hear the good news about your type of leukemia. Not fun for you, but at least it looks like it is a road to complete recovery, albeit tough on you until you get there.
    Thinking of you often and glad to get the updates - especially one like today's!


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