Chemotherapy Course Summary

Carl asked me recently how many chemotherapy "rounds" or "courses" he has been through. I didn't know, so I thought I would summarize them.  Websters dictionary defines a "course" of chemotherapy as a "series of doses or medications administered over a designated period".  Carl's doses of chemotherapy are three week blocks time.  He gets the chemo drugs to start the chemotherapy course, and the rest of the "course" is built in recovery time before he can get the drugs again. 

Dec 28, 2009 to Jan 1, 2010 Chemotherapy Course No. 1,
Main drug was Ifosomide, with concurrent radiation to the neck.

Jan 18, 2010 to Jan 22, 2010 Chemotherapy Course No. 2 - five days inpatient (meaning he stays at the hospital the whole time, overnight as well.)
Main drugs were Ifosomide and Adryomycin.

Feb 8, 2010 to Feb 12, 2010 Chemotherapy Course No. 3 - five days inpatient
Main drugs were Ifosomide and Adryomycin.

[ Feb 22, 2010 Pet Scan and MRI's. ]

Mar 1, 2010 to Mar 4, 2010 Chemotherapy Course No. 4 - five days inpatient
Main drugs were Ifosomide and Adryomycin.

April 19, 2010 Chemotherapy Course No. 5 
dose of ? on day 1 and day 8 with concurrent
[ April 20, to May 7, 2010] Weekday radiation treatments to the leg.

[ May 17, 2010 Pet Scan ]

May 24, 2010 Chemotherapy Course No. 6 - 
Day 1 and Day 8 dose of

Gemzar (also known as Gemcitabine) and
Taxotere, (generic name - Docetaxel)


June 24, 2010 Chemotherapy Course No. 7 - Day 1 and Day 8 dose of

Gemzar (also known as Gemcitabine) and
Taxotere, (generic name - Docetaxel)

July 12, 2010 Chemotherapy Course No. 8 - Day 1 and Day 8 dose of 
Gemzar (also known as Gemcitabine) and
Taxotere, (generic name - Docetaxel)

[ July 22, 2010 Pet Scan ]

Aug 9, 2010 to Aug 13, 2010 Chemotherapy Course No. 9 - five days inpatient
Main drugs were Ifosomide and Adryomycin.

Aug 31, 2010 to Sept 4, 2010 Chemotherapy Course No. 10 - five days inpatient
Main drugs were Ifosomide and Adryomycin.

Sept 24, 2010 to Sept 29, 2010 Chemotherapy Course No. 11 - five days inpatient
Main drugs were Ifosomide and Adryomycin.

[ Oct 4, 2010 Pet Scan ]

Oct 18, 2010 Chemotherapy Course No. 12 - Day 1 and Day 8 dose
Main drug was Irinotecan

Nov 11, 2010 Chemotherapy Course No. 13 - Day 1 and Day 8 dose
Main drugs were Irinotecan and Vinecristine

Dec 6, 2010 to Dec 10, 2010 Chemotherapy Course No. 14 - five days inpatient
Main drug was Ifosomide

Dec 27, 2010 to Dec 30, 2010 Chemotherapy Course No. 15 - five days inpatient
Main drug was Ifosomide

July 11, 2011 to July 14, 2011 Chemotherapy Course No. 16 - five days inpatient
Main drugs were Ifosomide and Etopocide

Lance Armstong only had to have 4 courses of Chemotherapy, according to Carl, who recently read Lance's book.
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Thanksgiving 2010

Thanksgiving was great. When you have 4 days off, like Carl did, you can fill the days with lots of relaxation AND getting together with friends AND movies AND TV AND cooking. Perhaps a silver lining of Carl's cancer is that we are getting better at enjoying the weekends.


Carl's 'hobby' of cooking has reached new heights in 2010, and the whole family is glad. So, over the Thanksgiving weekend Carl made the Thanksgiving dinner. He made a turkey awesomely, used his new super cool meat thermometer, etc.

Carl's neck has begun to really bother him. At the beginning of 2010, Carl got a prescription for Oxycontin, 200 pills. Until the middle of November, Carl rarely had pain the required him to use a pain killer, usually Motrin or Tylenol. But in November, Carl started taking more pain killers, including prescription pain killers, and over the Thanksgiving weekend his neck was in pain almost every day.

On Monday Nov 30, 2010, Carl had a PET scan to see how the new Chemotherapy (Irhineotecan and Vinchristine) are impacting the tumor. On Thursday, Dec 2, 2010 Carl went to the Oncologist. He was scheduled to start a 3rd round of Irhineotecan and Vinchristine. But the Oncologist said the PET scan indicated that the Irhineotecan and Vinchristine was not being effective, and the neck tumor is showing metabolic activity. DXXM. I was hoping the neck pain was because the tumor was dying, not thinking about growing.

This means goodbye to these 'nice' chemotherapy drugs that let Carl's hair grow, and only take 2 days of chemo infusion every 21 days. We had to schedule new chemotherapy drugs, and they will take longer to infuse. But chemotherapy is better then no chemo, so....

The Oncologist gave Carl a new pain pill plan, and on Friday Carl's neck was already in better shape, pain wise. Wednesday Carl's pain was so debilitating that I was really worried.

With the change in plans, we got to have a nice weekend of getting ready for Christmas, eating at a really good Chinese restaurant (Yen Chings), and shoveling the first snow this winter, visiting the Domes and Discovery World, and more. I hope you enjoyed your weekend and Thanksgiving.

October Update - Chemo Course 12

photo taken October 17, 2010


Fall colors, falling leaves, pumpkin farms, and yard work - October is more then 1/2 over, and we have been trying to enjoy autumn. The children are busy in school, and Anthony is busier then ever - being in the Homestead High School Play 'The Odyssey' means he can be gone from 6:30 AM to 9:00 PM at school, especially in this last week before the three performances on October 22-24, 2010. Carl had a brief break from Chemotherapy. Carl had inpatient chemotherapy at the beginning and end of September, three weeks apart, which resulted in him having no chemotherapy in the first half of October.

Visits to Froedtert continued, though. On Monday, October 4, 2010 Carl had some testing (a pet scan and a CT scan) to see what is happening to the tumor. The scan results showed that the tumor is not expanding, and is less active then before. Good News.

Carl has now completed six courses of chemotherapy with the effective and powerful drug Adriomycin (also known as Doxorubicin). The doctors won't be giving him any more. The patient that might have about a 2% chance of cardiac arrest after six doses of Adriomycin would possibly jump to a 18% chance with the 7th dose. Carl has now reached his maximum lifetime dosage.

On Monday, October 18, 2010 Carl had a course of chemotherapy with the drug Irinotecan, a new drug for him. It is the fastest chemotherapy session he has had, arriving at 9:00 AM and out by about 2:00 PM. On Tuesday, October 19, 2010 Carl felt well enough to go to work. Wow. Stay at home, relax, and recover; or distract yourself with a job you love? I understand that relaxing isn't so great when you are feeling under the weather, and I understand how distracting yourself from 'things' can work so well.

Carl will get a second dose of Irinotecan on Monday, October 25, 2010.

But before the 2nd dose, Carl and our family will watching Anthony in 'The Odyssey' - in fact, some of us will probably see every performance. Our whole family is looking forward to the weekend...

Banquets, Confirmation, Chemotherapy

Well, it felt great NOT going to Froedtert for 2 days, Tuesday May 11 and Wednesday May 12, 2010; after going for 16 consecutive weekdays. It practically felt like normal family living, or a mini vacation even. :)

Thursday May 13, 2010, Carl went in for blood work and to meet with our very nice Oncologist. The next steps were determined - a pet scan and then chemotherapy.

Friday, May 14, 2010, Nathan had his 6th grade Medieval banquet, (which we attended in costume, just as we did in Anthony and Tom's 6th grade year).


Carl didn't shave for weeks so he could look medieval. (Thankfully, he did bathe, so he did not smell medieval.)

He went back to work after the banquet, and shaved. I didn't immediately notice that Carl had shaved, but as you can see, Carl is definitely no longer bald.


Over the weekend, we celebrated Anthony's confirmation at church on May 16, 2010.

Monday May 17, 2010, Carl went in for a pet scan. I haven't seen the results, but apparently the scan shows no metabolic activity in spots outside of the leg. That is a good result, it means the tumor cells are not trying to grow, (I think). I'll describe pet scans in another post.

We then had a busy week with the family : Miranda's band concert on Tuesday; Anthony's band concert on Thursday; Tom's first baseball practice of the year on Friday. Carl has been continuing to work, and he is feeling fine and keeps up with the rest of us. (Which can be a hectic pace towards the end of the school year.) Carl does go to bed much earlier, and gets more sleep, and we are working on eating healthier. (More in a different post.)

The plan now is for Carl to start a round of Chemotherapy on Monday, May 24, 2010.

Carl could resume the 5 day inpatient chemotherapy, using the ifosomide & adriomycin combination. However, since the weather is so wonderful, and the cells seem to be behaving, The Dr's are going to use a second string of chemotherapy drugs so that Carl won't have to stay overnight at the hospital. Someday in 2010 Carl will get more ifosomide & adriomycin; but we can "save" those treatments for later in the year.

Part of the reasoning is this: The body can only tolerate so much adriomycin. Basically, you can have about 6 doses of this wonderful drug, and then your heart says skip it and you die. OK, that's not exactly technical. The body seems to tolerate about 6 doses. After the 6th dose your chance of cardiac arrest is about 2%. If you go for a seventh dose, your chances of cardiac arrest is about 18%, so they generally try not to give you more then 6 doses. Then you have to look around for other drugs to use to poison the tumor. So far Carl has had 3 doses of adriomycin, and the tumor seems to be responding - which means the tumor appears to be stopping it's metabolic activity - and not growing. We could use up our doses of the big guns (the Adriomycin), while the weather is great, (getting these doses over summer, with inpatient chemo); and then go to second string drugs, or take the second string drugs now and Carl will be able to "participate" in summer.

I hope we are doing the right thing, I've prayed on it and it seems to be the reasonable route. Things seem to be going well, and I thank you for your continued prayers. We are both looking forward to a "light" chemotherapy schedule, instead of dreading an inpatient chemo week.

Enjoy the week and the wonderful weather, we hope to!

Journey's Start 2009

Here is a question I have been asked, when did this all start? (When did you find out Carl had cancer? How did you find out Carl had cancer? etc.)

Sometimes you have been on a Journey for a while, and you didn't even realize it.

• 1993 Carl rips leg muscle running the Dinosaur Dash in Milwaukee Wisconsin.
• 1993-2008 Carl wears a compression band on leg to keep swelling and pain down.
• 2009 summer Carl notices he's limping. Others notice too.
• 2009 Late November Carl finally goes to see his Doctor. (I made the appointment and told Carl to cancel it if he wasn't going to keep it.
  
• 2009 Early December Carl has an ultrasound done on his leg, the ultrasound result - have an MRI.
  
• 2009 Dec 08, Tuesday:
  • 10:30 AM Carl had an MRI on his leg. Result - not good. See a surgeon ASAP.
    
  • Snowstorm that night.
• 2009 Dec 09, Wednesday:
  • 1:30 PM Meeting with Surgeon
  • I think the bad weather helped us get in to see the surgeon this early, because patients had canceled due to weather (??).
  • 3:20 PM blood work
  • 3:30 PM Biopsy on leg.
  • Very cold weather continues...
• 2009 Dec 10, Thursday:
  • 10:00 Carl had a CAT Scan
  • We got this appointment due to a cancellation due to the bad weather.
• 2009 Dec 11, Friday:
  
  • 8:00 AM Carl had a bone scan.
  • We got this appointment due to a cancellation.
  • 1:00 PM Meeting with Surgeon
  • My journal has this note summarizing what I heard of what the Doctor said about Carl's health
  • "MAN U R SICK!"
• 2009 Dec 12, Saturday:
  
  • We went to Breakfast with Santa.
  • On the way home, Carl's neck starts to hurt.
• 2009 Dec 14, Monday:
  • 2:30 PM Meeting with Oncologist
  • Diagnosis: High grade Sarcoma with Epithelial Characteristics. Or something like that.
  • 4:45 PM Flu Shot and H1N1 shot
• 2009 Dec 15, Tuesday:
  
  • Carl went to the dentist for a tooth cleaning totally unrelated to his leg.
  • That night, Miranda and Anthony preformed in a GREAT band concert.
• 2009 Dec 16, Wednesday:
  • A cancer tumor board discussed Carl.
  • 8:00 AM Carl had an Electrocardiogram
  • 10:30 AM Meeting with Lung Surgeon
  • 12:30 PM Lab for Blood work
  • 1:30 PM Biopsy on a rib.
• 2009 Dec 17, Thursday:
  
  • Carl went to work, didn't see any Doctors, and broke out in a rash.
• 2009 Dec 18, Friday:
  • 11:00 AM Carl had a Pet Scan, the first scan head to toe.
  • 1:00 PM Meeting with Doctor. He said what is causing that rash?
    
  • Chemotherapy scheduled to start the Monday after Christmas.
  • And that weekend, Carl's Dad came in for a welcome visit.
• 2009 Dec 22, Tuesday:
  
  • 11:00 AM Carl had a Port put in, for chemotherapy.

Photo above is Carl's Dad visiting Dec 18-20, 2009.


Photo above is Carl's Dad, Carl and the 4 children Dec 18-20, 2009.

Which brings us closer to Christmas.

But wait - a couple of plot twists are developing soon, so I will leave the Christmas Holidays for another post.

We are looking forward to the "Treat" in Treatments!