Monday, November 2, 2009

The Next Phase

Tomorrow Sam goes to the clinic to get his blood test and have a check up. The next phase will be discussed. Hopefully the blood work will show all is going to plan and the next phase can begin on Friday as planned. I'm celebrating turning 30 something that day while my little boy will begin the following:

CNS Therapy Phase

This phase is aimed at the central nervous system and lasts three weeks. It is expected that Sam will be an outpatient unless complication occur. We will be taking his temperature with a continued sense of dread! Sam will be given chemo intrathecally (into the spinal fluid) with four spinal taps over a two week period. Chemo will also be given by mouth, in the vein (his port) and into the muscle. Radiation therapy will also be given...I can't even get into that right now!

Here are the drugs for this phase:

*Methotrexate, intrathecal (spinal) twice weekly for 4 doses
*Cytarabine, intrathecal twice weekly for 4 doses
*Hydrocortisone, intrathecal twice weekly for 4 doses
*Vincrisine, In the vein Day 1
*Doxorubicin, In the vein Day 1
*6-Mercaptopurine, by mouth days 1-14 x2
*Dexamethasone, by mouth days 1-5 x2
*Asparaginase - may be into the muscle every week for 30 weeks or into the vein every other week for 30 weeks - this will depend on the randomized selection for the study he is on.

The use of doxorubicin in children with ALL makes it a highly curable disease, but because the chemotherapy kills heart muscle cells as a side effect, survivors can experience an improperly beating left ventricle, congestive heart failure, or arrhythmias that can cause sudden death. One study estimated that, even 25 years after they were treated, their risk of dying from heart disease is more than eight times normal. Sam will also be given Dexrazoxane which reduces the effects of the doxorubicin a little. Fingers crossed he is one of the lucky ones.

The radiation is designed to prevent any leukemia from coming back to the brain. The regular chemo is also about aggressive measures! It is hard looking at Sammy, who is quite the active chatterbox again, knowing he is about to get all this done to him. I know it is going to knock him sideways and there is nothing I can do about it....we are fighting cancer, (notice the lower case..I have no respect for it) and we intend to win.

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