Sunday, January 25, 2009

Some more details on Cycle Two

Mom received her new diagnosis which is Large Cell Neuroendocrine Tumor with Small Cell components.  Both large and small cell lung cancers are neuroendocrine tumors (arose from neuroendocrine cells). It appears she has a combined neuroendocrine tumor which explains why they had a hard time making the diagnosis. I believe her treatment plan will be very much the same as it was for small cell and she received the same chemo regimen as her first cycle.  The prognosis with large cell is better then small cell.  
Before each cycle mom must undergo blood tests to assure she can withstand the treatment.  All her blood numbers were good but they also test for different liver enzymes and functions.  When they tested the liver enzymes before her first treatment all the of the liver enzymes were slightly higher then the normal range and her LDH (one of the liver enzymes) was extremely high.  When they did the blood tests this time after just round of chemo all her liver enzymes had dropped into the normal range even her LDH which when from like 900 to 200!  This a really good sign that the tumors on the liver are shrinking as well as after the biopsy the doctor thought the lung tumor had shrunk significantly.  
Mom will have a CT scan the week before before her next cycle and will meet with a new oncologist at Reading that Friday.  We don't have an appointment at Fox Chase but we'll send them the CT results and consult with them over the phone.  The treatment plan shouldn't change unless the cancer isn't responding however as mentioned above we have some pretty clear evidence that it is working.  The nurse who set up the appointment with the Doctor at Reading said he was funny which will be a quite different then moms current oncologist.
Pretty much the cycle was the same as the first one.  We got better instructions on how mom should take the one steroid she was was given so hopefully that will make her feel better post-treatment.  This was the first cycle that we used the port.  Everyone I've talked to and everything I have read said that getting a port is the best thing you can do but I think the jury is still out on Mom's experience.  The first day went well except that mom can taste the saline when they push it which is rather unpleasant.  The second day we had to get the port reaccessed (they could have just left the port "accessed" leaving the needle in overnight with a piece of plastic over it) and the nurse really struggled.  Which was really painful for me so I can only guess what it was like for mom who was the one actually getting the needle jabbed in.  Mom didn't feel so well afterwards which may have been a blessing in disguise because then they ran an extra anti-nausea drug before her treatment on both day 2 and day 3 which seemed to help a lot.  Mom then decided to leave the port accessed overnight for the third day and after talking to several people it seems like having problems accessing a port is very rare so hopefully it won't happen again.  I have mint essence oils for her to smell when they are pushing the saline but we found that sucking on a strong peppermint lifesaver is stronger then the saline so hopefully that will make her more comfortable in the future.