11th chemo

11th chemo ✅ 

Well, there's good news and bad news. 

The good news is that I survived my 11th chemo session quite easily. I mean, I'm practically back to my normal "chemo days"!  

The bad news is that my pre-chemo test results came back with a very low white cell count, which meant we had to negotiate whether or not to do chemotherapy today at all.

Honestly, I had no idea about the tests and was feeling absolutely fine, but the doctor and I had to make a tough decision. In the end, we decided to go for half chemo - only Taxol, without the Carboplatin. Apparently, the Carboplatin kills white cells, which is why my count was so low.

By skipping it today, hopefully, I would also skip the aftereffects as well. I admit, I was terrified of having a repeat of last week's high fever and emergency room visit hanging over me.

And so far, I am back to my regular "after chemo days" as well -- I was starving, and as I need the high protein diet it seems, George and I went to Flaming Grill afterwards!  Having an appetite tends to indicate that everything is even better than it seems. 

I started to crash in a few hours after we got home, but fatigue is now a familiar friend.

2nd Chemo

At 7:10 am this morning it was already a familiar routine: 20 min drive, check in, IV, blood work, results and several hours in the infusion center. 

Today, to somewhat reduce George's anxiety, we decided that he would accompany me. This way George could see the process first hand, ask questions and hold my hand and feel useful. Gwen babysat Max and then went to work. 

For the 2nd chemo, my oncologist switched Benadryl to half the dose and in oral form instead of infusion, and lowered steroids a bit, though the rest of the premeds were kept intact. 

After all the premeds, I only had Taxol and Carboplatin for today's chemo, without the immunotherapy. Infusion wasn't as easy with pins and needles here and there, but absolutely manageable. Several hours later we were home around 2 pm. 

And, so far, no close acquaintance with the toilet, loss of appetite, or any other wonderful side effect, just fatigue (which is to be expected). 2 hour nap cured that!

As unique as I am, my side effects tend to show up four days later vs the next day. So we'll see what happens during New Year's celebration on Sunday.

Second chemo ✅

Treatment regiment

Dana Farber recommends doing TCK chemotherapy EVERY week for 12 cycles, then AC chemotherapy every two weeks for 3 cycles, then 3-6 weeks break to recover before surgery. Then 3-4 weeks after surgery another 4-6 weeks of radiation and immunotherapy IV every 6 weeks for a year.

In one sentence, the fun would last for a while, with the surgery sometimes in May/June 2023.

TCK: Taxol, Carboplatin, and Keytruda (Pembrolizumab)

AC:  Adriamycin (Doxorbicin) and Cytoxan (Cyclophosphamide) and Keytruda (Pembrolizumab)

Interesting, that Lahey has the same drug cocktail, as least for the first 8 cycles (didn't get much details beyond that), but every 3 weeks with much larger dosage, and worse side effects up front.

Chemotherapy 101

What have been told so far from Lahey-- the three main chemicals in chemotherapy are:

1. Taxol, 1 hour, weekly
2. Carboplatin, 1 hour, every 3 weeks
3. Keytruda or Pembrolizumab, immune system booster, every 3 weeks, 40 minute

Plus another drug cocktail the night before with some steroids, Benadryl, nausea medication. Still trying to get the full list of pre/during/post medications.

I wonder if this is standard protocol across all hospitals or will this differ when we hear our second opinion in a week?