VDC Cycles (rounds 1, 3, 5, and 7)
Vincristine - is a vinca alkaloid from the Catharanthus roseus (Madagascar periwinkle), formerly Vinca rosea and hence its name. It is a mitotic inhibitor.
Cyclophosphamide - is a nitrogen mustard alkylating agent, from the oxazophorines group. It is a "prodrug", and is converted in the liver to active forms that have chemotheraputic activity. It slows or stops cell growth.
Doxorubicin - is an anthracycline antibiotic, closely related to the natural product daunomycin, and like all anthracyclines, it works by intercalating DNA. The molecule was origionally isolated in the 1950s from bacteria found in soil samples taken from Castel del Monte, an Italian castle.
With "helper" drugs:
Dextrozoxane - will be used to help decrease the cardiac toxicity of doxorubicin
Flgrastim - will be used to help blood cells recover
Mesna - will be used with cyclophoshamide to protect the bladder
ICE Cycles (rounds 2, 4, 6 and 8)
Ifosfamide - is a nitrogen mustard oalkylating agent.
Carboplatin - introduced in the late 1980s and has since gained popularity in clinical treatment due to its vastly reduced side-effects compared to its parent compound (cisplatin). It interacts with DNA, akin to the mechanism of
Etoposide - is a tipoisomerase inhibitor which aids in DNA unwinding, and by doing so causes DNA strands to break.
With the "helper" drugs Filgastim and Mesna
*NOTE - all definitions are brief and come from Wikipedia so to find out more just do a quick google search if you are so inclined.*
So what are the side effects of these drugs? Since they are all about the same I will list them together and not by drug. I will split it up into 3 categories, Common, Occasional, and Rare. These side effects can occur immediately, or anytime during the cycle. When you hear drug side effects on TV it is easy to laugh and say, "Why would anyone take that drug if those are the side effects?" Well sometimes you don't have a choice, because the alternative is unthinkable.
Common Side Effects:
Damage to nearby tissue if the medication leaks from a vein
Loss of reflexes in the arms and legs
Abnormal heart rhythm
Worsening of side effects due to radiation treatments
Pink or red color to urine
Decrease in the number of red and white blood cells and platelets made in
the bone marrow
Decreased ability of the body to fight infection and disease
Loss of appetite
Difficulties or complete inability to have children
Bad taste when taken by mouth (MESNA)
Occasional Side Effects:
Burning, prickling, or tingling sensation
Damage to the liver
Weakness of the heart muscle
Abnormal hormone function affecting levels of salt in the blood and urine,
causing too much or too little urine
Bleeding and inflammation of the urinary bladder
Damage to the heart with abnormal heart beat or rhythm
Abnormal kidney function
Body loss of certain important salts and minerals (such as sodium,
potassium and bicarbonate)
Abnormal bone development
Allergic reaction (possibly severe and life-threatening)
Decreased or loss of appetite
Decreased blood pressure during the injection (ETOPOSIDE)
Worsens side effects due to radiation treatments
Local irritation at injection site
Ache or pain inside the bones
Increased levels of liver enzymes and uric acid in the blood
Low number of platelets in the blood
Rare Side Effects:
Abnormal hormone function affecting salt levels in the blood and
Allergic reaction (sometimes life-threatening)
Cancer caused by treatment for a previous cancer or leukemia
Temporary blurred vision
Heart damage with abnormal heart rhythms
Decay of muscle tissue in the heart
Damage or scaring of lung tissue
Damage or scarring of bladder tissue
Damage to brain tissue
Sudden kidney failure
Damage to the ear causing hearing and balance problems
Damage to the liver
Inability of the ovaries to produce eggs and/or hormones resulting in
inability to have children and/or hormone problems
Low blood counts
Pain during infusion
Inflammation of vein into which it was injected
Irritation of the liver
Pain in the arms and legs, and joints
Temporary low blood pressure
Enlargement of the spleen
Worsening of pre-existing skin rashes
Inflammation of a blood vessel in the skin
So here we are...
Zoë is battling cancer in round three of this war. She had a kidney study this morning to see if the tissue of the kidneys were getting enough blood supply, and to see if there was any damage to them. Both are doing great.
I did get to see images of the MRI done on Monday and that of the previous MRI, and it is shocking. The biggest thing in her abdomen is still the tumor. You have to picture her abdomen is 39 cm around at her belly button. With a tumor that is 8X7X4 cm. Again I don't have time to do the math on that...but I can say looking at the images that there is very little room for her other organs, even with her belly looking as wonderful as it is looking.
It looks like the doctors can say for certain that the tumor is not coming from the urinary bladder. I found this out this morning. So her bladder, and kidneys are all intact. The doctors now thing that it is very likely that it is
coming from her right uriter (the one that is obstructed by the tumor.) Although they are not ruling out the possibility that it could be coming from somewhere else. The reason why it is so hard to tell where it is coming from is
because it is pushing against her organs, making it hard to see where the tumor ends and the organs begin. With the most recent shrinking the tumor lifted itself up off of her bladder and hence the doctors being able to see that the bladder is intact. Hopefully this round of chemo will shrink the tumor even more so that the doctors can confirm their suspicions.
So what does this mean for her right ureter? Well from what I read about Ureteral Reconstruction it is not as easy as just replacing a tube with another tube. But it is also not impossible. I personally believe that it is way better to have to figure out how to re-plumb the kidney to the bladder than to have to replace a kidney, or a bladder. So yay for the tumor not coming from those organs, and lets cross our fingers it does not come from a really difficult place.
Zoë may be going home next week. It sounds like the doctors want her to go home before the surgery. I am so scared about this still. I am really hoping that she can stay here during this round of chemo. She is so small, and her condition although stable is still very serious. Not to mention the nephrostomy tubes...etc...see previous posts about fears...
So I have received lots of responses from folks out there saying they cannot believe how funny I am in some of my posts. Well I think a good part of that is my type of humor. I have always gravitated to the deep dark, twisted,
wrong humor that makes you cringe then laugh. Is there humor in cancer? I think so. I don't think it is a joke, I don't think that the pain, or discomfort is funny. But there is a lot of things that you can laugh about. The nursing staff and I laugh all the time about, and with Zoë. There are moments where if you don't laugh you will go crazy. There are crazy moments that will make you cry if you don't laugh, and sometimes I cry until I laugh. Although I don't think that I have had a cry since the phone melt down with my mother several weeks ago. Maybe I am due for one soon?
So where is the humor coming from? Maybe it is a defensive strategy on my part, but really I think it is just my normal personality to make light of the harder things in life. Gosh, just reading that list of side effects can make
you go nuts if you don't crack a joke about how one med will cause constipation, and one diarrhea so I guess Zoë should have some normal poops? Right?
When thinking of this situation I am reminded of the lyrics, "No one laughs at God in a hospital", by Regina Spektor. No, I guess I am not laughing at my higher power. But I am certainly having the best time I can with 'em.
And why not. Not to be really morbid, but if we are only granted so many opportunities for moments in life with those we love, then why not make each one awesome? I am still taking each day as it comes. I am still refraining from Internet searches, and my imagination is still in a time out, and instead of using my energy to fret I am using it to laugh both with and at my little warrior, and at myself.
This post is brought to you by the power of laughter.
Love and Hugs!