Karen received her sixth chemotherapy treatment from January 28th to 30th. Each time before chemo, they do some blood work. I've mentioned the blood cell counts before. Early on there was a problem with white blood cell count, but the shot of Pegfilgrastim (aka Neulasta) they give her has managed to bring those numbers above critical. However, red blood cell count and hemoglobin have continued to fall. Another thing they monitor are tumor markers. These are substances that often become elevated in the body when there's a tumor. Two of these, CEA and CA19-9, have slowly been climbing. They are only hints, as other things can elevate these numbers. For example, smoking can raise your CEA levels to those found in cancer patients.
The plan was always to have some bloodwork and another CAT scan done at Mayo Clinic after the sixth treatment. This was done yesterday, and we saw the oncologist at Mayo today. The good news is that the CAT scan is clean. There were no new growths. Surprisingly, the bloodwork showed that her CEA had dropped drastically in just the week since her last bloodwork. It's actually the lowest it's been since starting chemotherapy.
Her CA19-9 however, continues to climb. While this can be a sign of something bad, the doctor says it's still possible these numbers are just a reaction to her extensive surgery. And we'll just continue to watch the levels for now. Her hemoglobin has also now fallen into critical range; this explains some of the weakness she's been feeling. They suggested she get two units of blood, and being eager to feel better, she agreed. She received both units of blood over roughly 4 hours. Hopefully this helps with her energy levels.
The doctor says, assuming CA19-9 starts to drop, and CEA stays low, the plan will be to continue chemotherapy as is for another 6 treatments. Everyone we've talked to - even the Oncologist at Mayo who warned us heavily about neuropathy becoming permanent - seems reluctant to reduce the Oxaliplatin. Karen isn't too happy about this, but seems willing to hang on to the full dose as long as she can. On the bright side of things, this means she's officially half way done with this round of treatment. A month or so after she finishes treatment, they'll do another cat scan to check for any growth or changes. And then just watch it very carefully.
