The Treatment Schedule: Part One, Induction
The eve of a Chemo day is the most unnerving. As the evening turns into night, I feel my stomach start to curl up. It takes a minute or two for me to realize that I am already feeling the anxiety that taking a three year old to her second round of outpatient chemo produces. Before I get completely submerged into the feeling state, let me explain as easily as I can.
- The primary treatment phase is called Induction, which basically just means its the introduction of the patient to the treatment plan.
Each patient, I suppose receives the same treatment plan. For example, Day 1 includes Vincristine. BUT, each patient has a different level of vitality. Note that Aubrey, who was diagnosed just 30 minutes prior to Isa, remained in the hospital a week longer. Her arm became infected and thus affected the plan somewhat.
- This phase can last from 28 days upward to 36 or more days.
- The start and stop of each phase is based on testing, of the blood, of the bone marrow and of the Cerebral Spinal Fluid (CSF).
Last week Isa had the Lumbar Puncture, aka Spinal Tap, to check for blasts (leukemia cells) in her CSF, as well as to inject some CANCER killer (Intrathecal Methotrexate.) According to one article I read, the cells can HIDE in the spinal fluid. Because the chemo in the veins won’t reach this area, they take care of it separately.
I mentioned the medicines they use in a previous post, The Next Step.
So EVERY time we go to clinic the nurses draw blood to run a Complete Blood Count, or CBC. This tells us how she is progressing. Additionally, the Spinal tap tells us if they can see any cancer cells there, in the CFS. Also, the bone marrow test tomorrow will tell us a percentage of cancer cells in her marrow. Ideally NONE. But more realistically there could be a low percentage.
GOOD NEWS: Because Isa had no blasts in the very first lumbar puncture she received during her port insertion, she will NOT receive two of the four spinal taps scheduled during the typical induction phase.
On DAY 28 Isa will receive BOTH a lumbar puncture and a bone marrow aspiration. This is a good thing, because these are the tests that will say she has gone into remission. These are the tests that when they come back will indicate that she is doing so well that she can be finished with induction.
- At any point during this time any of these procedures can change, based on the results of the CBC, cultures taken, infection, or fever. I am sure there are few other things that can change this up too.