Paul's Heart

Preparation For Chemo – Part 2

So the first pre-chemo testing I underwent was for my future life after cancer.  The next set of testing was to determine my body’s ability to tolerate two particular drugs in the chemo cocktail.  Newbies will likely recognize the drugs, Bleomyacin, and the other, Adriamyacin.  I would be given seven total drugs, four at one appointment, the other three the following week.  Both of these two particular drugs would be administered in the second week of the cycle.  Blood tests would be done weekly for the duration of my treatment schedule, eight months, or “cycles” in the cancer world.  Any delay makes it longer than the months, so that is why “cycle” is used.

As far as the drugs and what they do, what they cause and such, that will be in an upcoming post very shortly.  But in preparation for the chemo, what you have read here, is basically all the knowledge that I had at the time.  All that was explained to me, was that the two drugs mentioned above were known to potentially cause issues to the body.  Adriamyacin could have an impact on the heart, and Bleomyacin could affect the lungs.

Now here is where progress has changed from 1989.  In 1989, the tests that would be administered to me, would be for the purpose of seeing if my heart and my lungs would be strong enough to take the pounding from the drugs.

A MUGA scan would reveal the blood flow in my heart.  A pulmonary function test would determine how strong my lungs were.  Again, it was this simple.  With both tests completed, and results negative, chemotherapy would begin as soon as scheduled.  As expected, I had no issues with either test.  My heart was strong and so were my lungs.  Chemotherapy would begin in days.  I was handed several pamphlets with information on the drugs I was going to be given and my appointment was made.

And that is what I knew then.

This is what I know now.  One of the few times I will spoil my story (you already know my long term health issues from my treatments), this is what these tests now provide.  Yes, they still confirm that your body is strong enough to take these drugs, but they also serve as a “base-line.”  In other words, the numbers on these tests, will be compared following future cycles, and if anything comes up like complications.

You see, the Adriamyacin, though critical in the standard treatment regimen, has the potential for damaging the heart so badly, you could end up with CHF, congenital heart failure.  The drug damages the heart so badly, that if left undiscovered, a heart transplant is necessary.  And you cannot get a heart transplant for up to five years post-chemo.  Unfortunately for me, and for those not considered “newbies,” we were not followed up this way.  Whatever happened at the end of our treatments happened.

But I reported on an earlier post a long time ago, technology available, that can discover this damage after the first or second treatment, before it gets too bad.  This would allow either a modification of the dose, or use of a different drug.  A simple ultrasound after each cycle can keep track of this progress.  To be fair, this issue affects only roughly 5% of the patients, so until recently, it was not considered that big of a concern.  That is, unless you are one of the ones facing CHF.

Both tests are easy to go through.  They are non-invasive, and over in minutes.  But the information that they provide prior to, and now during, and after, is critical.

In part 3 of this series, an epic showdown with my oncologist that almost stopped my treatments.  One of the few times I have been able to prove… there is an “I” in “team.”