More Bits of Health News

TLDR: better outcomes than expect have been observed with the regimen I am now on when given after failed immunotherapy (my situation); side effects from chemo three days out from the first session have been minimal.

So ... on Wednesday, I had my first round of the new chemo regimen. It's a little intimidating, since he immunotherapy is generally much easier on the patient. It amounts to letting your immune system run a little bit wild.

The downside for me was that the immunotherapy might attack the replacement part I've got (kidney - not OEM, but probably better. Thanks! Brenna). Fortunately, things didn't seem to go too badly on that front. But the immunotherapy just wasn't doing any harm to the melanoma either. It was definitely doing things though as it triggered colitis. After stopping that and bumping the prednizone up a bit, the colitis has been getting better -- just about completely gone so far as the symptoms are concerned now.

Chemotherapy is essentially toxic -- and the hope is that it is more toxic to the melanoma than it is to the rest of me.

The first bit of good news was relayed by my Sanford oncologist, Dr. Sumey, from my oncologist at Mayo, Dr. McWilliams. The regimen I've just started has something like a 25% chance of shrinking the melanoma and a better chance of halting its progress. The news was that, anecdotally, Mayo has seen a significantly better percent of patients show definite improvement on this regimen when it is done after unsuccessful immunotherapy. Every individual is different, but I can't complain at all about hearing that the chemotherapy has been observed to work better!

Second bit of good news: so far, the chemotherapy isn't causing any horrendous problems. The first bullet dodged was an anaphylatic reaction -- a very quickly occurring potentially fatal allergic reaction -- if it had happened, I believe that would have required an immediate halt to the chemotherapy. Continuing in that vein, three days after the infusion, I haven't had any other signs of an allergic reaction or other trying side effects. Yeah!

This doesn't mean I'm out of the woods. Apparently, the effects of this regimen tend to hit the worst at about five days out ("the trough"). The most common problems are fatigue, nausea, and vomiting. No nausea or vomiting at all so far. I've been very tired, and sleepy, but that could be any number of things -- including the anti-anxiety medicine they prescribed as a sleep aid. Apparently, the chemotherapy can make it harder to sleep, just as prednizone can. But -- I'm going to have to look up and add the med name here -- the <medicine> has allowed me to nap and sleep fairly easily and well. Despite a good long night's sleep, I'm waking up a bit like an ent -- rather slowly and feeling a bit wooden. I attribute that to the med. But the sleep itself has been longer and better than any in recent memory. (Apparently a bit of snoring, too, if I fall asleep on my back.) I've been doing a fair bit of napping as well.

It was the first week of classes, and that certainly contributes to exhaustion and my markedly better skill at napping. I'm working with six different co-instructors on six different courses this semester. It's starting out really well, but it is a challenge to communicate a whole philosophy and approach to teaching game design and development to people who have only been peripherally involved in the past. My co-instructors have all been wonderful so far, but I'm trying to lay a really solid groundwork in case side effects or symptoms get worse and I'm less able to.

Nausea and vomiting were the other side effects I was given meds for. Two different ones. So far, no need to take them at all. But my impression (from the dr. the nurses, and the meds subscribed) that vomiting is likely. Hoping to continue with no need for these meds.

One other side effect is increased susceptibility to infection. This is old hat for me. Essentially back to being as careful as I was right after the kidney transplant. It was only a year or so ago that I got the OK to eat sushi again. Now it's off the menu. <sigh> Fortunately, I got a nice dinner at Oshima in Sioux Falls after my last PET scan and before this regimen began.

Another, very likely side effect is hair loss. After doing some research, preemptive measures seemed in order, so I'll be posting a new picture. Gone back to my roots and the haircut I had when I was a four-year-old! (Hair care just got immensely easy!) But I may need advice on hats. I also think the look is a bit more metal, particularly when I'm wearing my Arcana hoodie.

Some (most?) of the side effects from chemotherapy get worse over multiple infusions. So, I'm not expecting such an easy time of it for the long run. But it seems likely that the better things are going at the beginning, the less bad they will be towards the end of the course of therapy (looking at something like 6-8 infusions at three week intervals).


cheers,
skg