Things about Sam and Leslie

Sam and I keep hearing the same excellent questions about chemotherapy and his schedule.  Up until a few weeks ago, we never understood how the whole chemotherapy thing worked.  Our heads spun wildly at our first meeting with our oncologist who came up with the chemotherapy treatment and schedule.  I was left staring blankly at Kate’s rigorous note-taking.  We refer to her unbelievably thorough notes frequently.

Sam and I recently talked about our chemotherapy knowledge prior to the last several weeks. Even though we have known several people who have received chemotherapy, we had never thought about all the details.  The only thing we knew was that chemotherapy was usually associated with hair loss.  Here’s a bit of the education we’ve gotten over the last few weeks.

Chemotherapy is a type of cancer treatment that uses drugs to destroy cancer cells.  It works by stopping or slowing the growth of cancer cells, which grow and divide quickly.  While it’s busy with the bad cells, it also harms healthy cells (it doesn’t know the difference).  This damage to the healthy cells is what causes all of the side effects that we have mentioned.  The most common side effects are fatigue, nausea, vomiting, decreased blood cell counts, hair loss, mouth sores, and pain in general.

Chemotherapy means a million different things.  It refers to countless drugs, is administered on whatever schedule the doctor decides, and every person reacts differently.  Some people don’t have any side effects while receiving treatment and others suffer quite a bit.  The side effects depend on the types and amounts of drugs one gets and how his or her body reacts.  Consistently, we are encouraged and reminded to not listen to other people’s chemotherapy horror stories because each chemo treatment regimen differs so greatly.

Sometimes, chemotherapy is used as the only cancer treatment.  But more often, cancer patients will get chemotherapy along with surgery and radiation therapy.

Chemotherapy can be given in many ways:  injection (like a shot), intra-arterial (the chemotherapy goes directly into the artery that is feeding it), intraperitoneal (the chemotherapy goes directly into the area that contains the organs such as the intestines, stomach, liver, and ovaries), intravenous (the chemotherapy goes directly into a vein), topically (a cream is applied to the skin), and orally (pill).

Sam receives his chemotherapy intravenously through a portacath that is located in his chest beneath his skin.  We call it his POWER PORT!  It is a cylinder with a hollow space inside that is sealed by a soft top. It connects to a small, flexible tube (catheter) that is connected to a vein. When a needle is put into the soft top of the port it creates access to Sam’s bloodstream, meaning that medications and fluids can be given and blood samples withdrawn.  Sam had to get his power port installed (put in by means of surgery) prior to receiving chemotherapy.  His incisions have healed nicely and you can’t tell that he has a purple power port in his chest.

Chemotherapy is given at the infusion center, which is not nearly as exotic as it sounds.  At the infusion center at Vanderbilt, there are 44 small rooms.  All of the rooms have a few comfortable chairs and a flat screen tv with a DVD player.  Some of the rooms have beds.  These rooms are usually for the sicker patients or the patients with testicular cancer.  There aren’t any doctors at the infusion center but there are a lot of loving and funny nurses.

Because Ewing’s Sarcoma is very aggressive, Sam’s chemotherapy regimen is also very aggressive.  Sam is currently working on an every other week chemotherapy schedule.  Two weeks ago, he received chemotherapy for two days (four hours each day).  During this cycle, he was given three different chemotherapy drugs.  This coming week, Sam will have five straight days of chemotherapy that will be administered for six hours each day (totaling 30 hours of chemo for the week).  During this treatment, he will get two different chemotherapy drugs.  That makes a total of five different chemotherapy drugs.  In addition to the chemotherapy drugs, he gets anti-nausea medication, steroids, and bladder medication.  Chemo nurses have very important jobs.  Each nurse that has worked with us has been incredible.

As long as Sam’s white blood cell count stays above a certain level, the oncologist will keep him on this schedule until his surgery.  The white blood cell count is important because white blood cells are cells of the immune system that defend the body against infectious disease and foreign materials.  During Sam’s off weeks, he has to get his labs drawn and we meet with the oncologist to make sure we’re ready for the upcoming week.

Here is Sam’s tentative schedule:

Chemo Schedule

About two weeks after his surgery, he’ll start chemotherapy again on a different schedule.

This weekend has been beautiful and we have enjoyed each minute of it.  We are ready for this week.

Love,

Leslie and Sam

Sam's last big meal before treatment. Two cheeseburgers with a side of fries and another cheeseburger.