Tuesday, September 11, 2012

The EPOCH epoch

Andrew has been recovering slowly from the 2nd round of ICE.  He needed several transfusions of platelets and one transfusion of RBC's, which were handled by Dr. W here, near home.  On Friday, his platelets were still very low, and I knew that meant Monday's treatment would be delayed. Monday, I talked to Dr. Z's nurse at MSK, and she told us that Dr. Z wanted to see Andrew today for a bone marrow biopsy.  Andrew was not happy, to put it mildly -- bone marrow biopsies are his least favorite procedure!!  But he got on the train like a good cancer patient and headed into the city.  I was unable to join him as the short notice made it impossible with the kids' schedules.  Dr. Z ended up deciding against the biopsy (hooray!), but told Andrew he would be admitted immediately to start chemo -- what?!  His platelets are still low (though much better), but Dr. Z said he didn't want to wait any longer and give the cancer a chance to grow again.

"We've been talking about you a lot" he said. Gulp. Much better to be the patient they don't need to talk about a lot, isn't it? The tumor board has been poring over his case and his very stubborn cancer.  They initially wanted to do the bone marrow biopsy to see if they were dealing with 2 very different types of cancer, but eventually decided that it was most likely not so.  Instead of continuing the ICE or the IVAC regimens discussed earlier, the group and Dr. Z decided to give Andrew a 96-hour continuous infusion called EPOCH.  This is a cocktail often used for very stubborn cancers that have developed chemo resistance.  Studies have shown that a continuous infusion at low concentrations can sometimes be more effective than brief, high dose infusions for chemo resistant cancers.  The plan is to get the 4-day EPOCH (that just sounds so weird -- a 4-day epoch), get another PET, and if necessary do another 4-day EPOCH cycle.

Has anyone ever had as much chemo as my husband?! Lordy. Hopefully, the EPOCH does the trick and we move onto transplant!

No comments:

Post a Comment