Lauren had her 1st dose of chemotherapy today (Actinomycin-D). She goes in again tomorrow for a second chemo drug (Vincristine). So far, so good. It was a little traumatic for her to get her port-a-cath accessed, but she survived. We are going to try a numbing cream instead of numbing spray next time to see if this helps.
Her lab work was reassuring WBC 8,000 (normal 6,000-17,000) and ANC 1800 (normal 1500-5000). She also received an antiemetic that should work for 24 hours. We have Zofran for any breakthrough nausea as well and pain medication for pain control. She also got a fluid bolus because her appetite is still not back, and we are having a hard time getting her to drink anything! Now for the weekly regimen to begin. . .Septra twice a day Mon/Tues each week (an antibiotic for prophylaxis - to prevent pneumocystis pneumonia, a very dangerous form of pneumonia that children with cancer are at greater risk to develop) and chemotherapy each Wednesday.
She gets lab work each week before her chemo and also will get various tests (CXR, CT scans, and ultrasounds) throughout the course to check for any metastatic cancer.
Her final pathology report is back. She has nephroblastoma AKA Wilms tumor, favorable histology, stage 2 cancer. The next step is to determine if she has LOH (loss of heterozygosity - studies show that tumors with certain changes on chromosomes 1 or 16 seem to be more likely to reoccur after initial treatment). This test will be back in another 7-10 days. It will determine if she is treated for 25 weeks with an additional chemo drug vs the standard of care with 18 weeks of 2 chemo drugs. Only about 5% of Wilm's patients have this, so chances are good that her test will be negative.
She is a trooper and has done amazing. As long as she has some sort of Disney princess to play with all is well. We are just starting this long journey, but so far things have gone as well as can be expected. We are praying for continued success.