Chemotherapy

My friend Tracy asked what my chemotherapy treatment entailed and I wrote her back. I then thought it might be something worth posting so you could have a feel for what R-ICE chemotherapy is like....

My chemotherapy, right now at least, is given by peripheral IV(meaning IV in my arm). It’s a four day treatment. On the first day, I am given steroids, anti-nausea drugs, ativan(relaxant), benadryl and an anti-vomiting drug(these are all pills). Then I wait a little bit, then they give me a 1 hour IV of drug called Etopocide, which specifically targets and kills young cells in my bone marrow. After that hour, they give me a 4 hour IV of a monoclonal antibody called Rituxan. Rituxan attaches itself to cancerous white blood cells and has an affinity for the chemotherapy agents administred on the second and third day. It acts to target the cells for destruction. After all this, (it takes about 5-6 hours), I go home and rest.

On the second day, I am admitted to the hospital and given the same premedications as the first day. Then they give me another 1 hour round of Etopocide. Then, I’m given a 1 hour round of Carboplat, which is a platinum based chemotherapy drug that kills blood cells throughout my body. Finally, they hook me up to a giant bag of fluid and begin administering the Ifosfomide. This is the granddaddy of bad dudes. Its so caustic, they have to mix it to a very thin solution, and administer it over 24 hours. Also, while they administer it, I am given IV fluids and electrolytes. Additionally, they make me drink as much fluid as I can stand. Without all the extra fluid, my bladder and kidneys would be burned so badly I would go into renal failure, and that’s not good.

Needless to say, I pee A LOT. And they capture all of it and test it to see if there’s any damage occurring to my kidneys or bladder. After the 24 hour drip is done, for good measure, they give me another 1 hour round of Etopocide and send me home to whimper in my own bed. The next day, I return for a Neulasta shot. Neulasta is a drug that stimulates my bone marrow to produce more blood cells and platelets.

My blood counts fall to 1/3 of their normal levels shortly after I leave the hospital. This causes all kinds of issues, like being dizzy, having no strength or stamina, and potentially can cause severe oxygen depletion in my major organs should I do too much(which thankfully I haven’t had). I will return to the hospital Monday, Wednesday and Friday next week to have my blood tested. If my counts are too low, they will give me blood transfusions to help keep oxygen levels in my body high enough. Fortunately, through two rounds of this treatment, I have not had ANY transfusions. My doctor cannot believe it. Nor can he believe that my blood cell counts returned to normal after 8 days following the second round of treatment. I am the only patient he’s ever had who did that.
Pretty amazing really. I can’t believe how lucky I am. I also cannot imagine how tough this must be for people who don’t bounce back so well. My heart goes out to them. I feel like crap, and I handle it pretty well.

Anyway, sorry this is so long, hope it helps. I’ve got to run. I have a date with an Etopocide IV.