Change in Plans...

Deb and I drove to the chemotherapy center this morning and, in preparation for the chemo session, I had some blood tests done -- all of which had been strictly routine up until today.

But this morning, my white blood cell measurement was one point two or thereabouts. Before my first chemo session, that measurement had been six point something-or-other. In any case, it was much too low to allow me to do the chemo session.

My chemo doc explained that the effect of the Cisplatin regimen was cumulative, and that we were close to the "nadir" (i.e., low point) of blood count measurements residual from the second session. And that the white blood cell count before the second session was acceptable, but still much lower than the initial six point something.

Bottom line: he would not proceed with the chemotherapy session. And, since we were so close to the end of the radiation therapy sessions, he was simply going to cancel the third chemo session altogether. He reminded us that, at the start of the treatment weeks ago, he had told us that there would be "two or three chemotherapy sessions." I don't recall that, but hey.

He said, "If we proceeded with the back-to-back chemo sessions the way we had planned -- given your extremely low white blood cell count, I could guarantee you a week's stay in the hospital trying to recover." [What he's alluding to is the fact that chemo sessions destroy many types of fast-growing cells in the body, including cancer cells, of course, but also white blood cells. So another chemo session at this time would drive the white blood cell count down dangerously low.] He mentioned that is absolutely conceivable that a poorly thought-through chemo regimen could kill the patient. And that's why they do these blood tests in the first place.

As it was, he told us to take my temperature twice a day and report any signs of fever or chills immediately. And stay away from crowds. And rest a whole bunch.

(But, come to think of it, this low white blood cell count may explain the serious fatigue -- the wet cardboard box thing -- that I blogged recently.)

So we took this information to the radiation therapy doc, who decided to postpone any radiation treatments until my white blood cell count improved. Between the skin cracks and blisters now showing up on my neck -- a direct result of the radiation treatment -- and the ulcer under my tongue, there were numerous vectors where infection could invade my body and I do not currently have enough white blood cells to protect me from serious illness.

So rather than having two carefully timed treatments today -- which was the "one-two punch" plan I'd been looking forward to -- we got bupkus.

Now, assuming that the previous treatments have been fully effective and there are no cancer cells remaining in my body, this is kind of good news. It allows my white blood cell count to begin returning to normal weeks earlier than it would if I had another chemo session and it provides a break for my tongue to do some healing before we finish up the radiation treatments. Which might start up again on Thursday or next Monday or who-knows-when. It all depends on the blood count. And the count necessary for radiation to resume is probably lower than the count for another chemo session.

Still, it's disappointing as well. I want to clobber this cancer stuff and then clobber it again. And no one knows if the previous treatments have been thoroughly effective. So I was really looking forward to the double whammy that today was scheduled to be.

If there is a serious postponement in the radiation, would the chemo doc consider reinstating the third session? Dunno.

I will get scans (PET? CT? MRI? dunno that either...) in a month or so to see if anything is still there and growing. More later...