Riding for Roses

Today we are back from our vacation and Spencer started his second cycle of delayed intensification. The good news is that after eight more weeks of this, he should be on maintenance for the remainder of his treatment which will be in late 2007 or early 2008. The bad news is he has eight weeks of intense chemotherapy and a resulting immune system crash to end his summer, which had barely begun.

Delayed intensification starts with a big day. He had a checkup with the oncologist, a bone marrow aspiration, a lumbar puncture with intrathecal (through the spine) chemotherapy with methotrexate, a two hour infusion of doxorubicin (which some call the “red devil” for its color and side effects), and IV vincristine (which is a slow injection – about 2 minutes). In addition, he got loaded up on Anzemet and Zofran to prevent nausea and started 7 days of dexamethasone (a steroid). The next couple of weeks continue the doxorubicin and vincristine, but without the procedure.Then, after a checkpoint with a pause if blood counts are too low, he has the second half of the intensification with cyclophosphamide, thioguanine, and (my favorite, the at-home infusions) cytarabine.. Naturally, he’ll get another procedure for intrathecal methotrexate to kick off the second half. Based on last time around, we expect his hair will start falling out soon and his immune system will crash sometime around the last day of the Tour de France. More on why that date is relevant coming soon to a blog near you.