I received good news and bad news this week. My CT scan results shows the abdominal lymph nodes have significantly reduced in size, but my immune system was far too weak to start my 3rd round on schedule.
Last week I had several tests to show that the chemotherapy is having the intended effect of eliminating the cancer and to determine the extent to which it’s having some unintended effect of pulmonary toxicity. First, I had the pulmonary function test. Bleomycin is one of the chemotherapy drugs I’m receiving that is notable for its lung toxicity. Many patients experience minimal lung toxicity while it can on occasion significantly reduce lung function. My oncologist has had a patient on Bleomycin who ultimately required a lung transplant.
Because of this risk I took a pulmonary function test prior to starting chemo. Last week I took another pulmonary function test to determine if the two rounds of Bleomycin have significantly damaged my lungs. Happily, my pulmonary function test showed that it was nearly unchanged. My lungs are operating at 100% of the anticipated capacity.
While this is down very slightly from my pre-chemo test which was slightly above 100% I’m hoping the difference is mostly due to conditioning. I’ve been going through chemo for 2 months now and have barely worked out in that time. Regardless, my lungs should be more than equipped for any future marathons.
Next I had a CT scan. There was some logistical confusion as the hospital had not appropriately cleared the CT scan with my insurance company before the day of the procedure. My oncologist was out of the office for a planned conference when the insurance company came back requesting approval. Somehow his backup and his backup’s backup were also out of the office and my CT scan was not addressed. It took some convincing at the hospital’s office but my mom and I were ultimately able to get a 4th oncologist to respond to the insurance company’s request so that I could get my CT scan on time ahead of my 3rd round of treatment.
Thankfully, the CT scan showed that the chemotherapy has significantly reduced the size of my abdominal lymph nodes and has been effective at clearing the cancer. While it wasn’t very likely, there was a small chance that I had a chemo resistant embryonal carcinoma. If that was the case my options would have been limited. I would have likely required extensive and invasive surgery and my prognosis would be significantly worse.
The only unfortunate news I received was that, as with the 2nd round, I needed to delay the start of my 3rd round of treatment. The chemotherapy has significantly harmed my immune system and starting the 3rd round now would have possibly eliminated all my remaining white blood cells. This would have resulted in me possibly becoming an inpatient at the hospital receiving intravenous antibiotics. Delaying my treatment is not helpful in fighting the cancer, but was just too dangerous to go forward.
I should be starting my 3rd round next Monday. I’m confident my white blood cell counts will be well above the level needed to proceed by then. Hopefully my tumor markers will be down by the end of the 3rd round and it will be the end of my treatment!