Next Up...Chemotherapy

We had our follow-up visit with the oncologist in Friday, and they finally had all of John's test results. The good news is that his PET scan was clear, and all his tumor markers returned to normal. The other news was that the pathology of his tumor showed that he has two types of cancer in the tumor. The first is embryocarcinoma, which is fairly common and not terribly aggressive. The second is choriocarcinoma, which is rare and much more aggressive with a higher chance or recurrence. Usually when a choriocarcinoma does recur or metastasize it shows up in the bone, lung, or brain, which would obviously be not good. That being said, he has a Stage 1 choriocarcinoma which is highly treatable, and in fact, even more rare because usually by the time someone is diagnosed with this type of cancer they have already advanced to Stage 2-3. In this sense, John is extremely lucky to have had intervention this early.

So with all that comes treatment. He still has to have an MRI of the brain this week to insure that the cancer has not spread there at all. From the way the doctors sounded, they do not believe that is has spread (based on all the other test results), but they still have to do this last MRI to be sure. Next comes chemotherapy. John will be going through 3 cycles of chemo therapy, each cycle lasting 3 weeks, so 9 weeks in all. We have a teaching session scheduled for this Thursday with one of the oncology nurses, where they will go over the procedure, the side effects, etc, and we are supposed to come armed with all of our questions.

His first cycle of chemotherapy begins on Dec 15th. The 3 week cycles are broken down as follows:
Day 1-5 - come in for chemo each day for about 5 1/2 hours, may experience nausea, fatigue
Day 6-10 - at home, probably will feel okay
Day 11-17 - at home, will feel the most fatigued and weak, since this is the stage where all his blood counts will be depleted from the meds. Will be most susceptible to infection, so definitely can't be at school around kids
Day 18-21 - will be feeling better, recovered for next round of chemo (to start Jan 5th...and round and round we go)

His doctor has said that he cannot work during any of this time, not only because he will be feeling pretty lousy, but also because chemotherapy depletes the immune system, especially during Day 11-17, so being around school kids with all the stuff they carry, would be too risky. Even a common cold would be very dangerous. In fact, were supposed to monitor his temperature. If he starts running a fever at all, he will be admitted to the hospital for IV antibiotics. His boss has been very supportive through all this, and his district has approved his medical leave for the 9 weeks that he will be going through the cycles.

That's all for now, we'll keep this blog posted with updates on John's treatment.