I met this morning with my oncologist, Dr. Grapski, of the Thomson Cancer Survival Center (link to the right). Blood tests showed I'm in good shape to start cycle three of Xeloda -- took a first dose after leaving his office, and the second just minutes ago. We've begun tracking my tumor marker, ca 19-9, the levels of which have proven to be a solid indicator of the activity and growth of my cancer. My ca 19-9 from 3 weeks ago was at around 300. While this is high (normal is below 35 or so), it doesn't mean much by itself -- when we can compare it to today's number, that's when it'll be significant. We'll see...I don't have a feeling either way. I've had it as high as in the 400s...I've had periods where I've been happily "normal". Right now, we just hope to see it go down.
We set up a CT scan for mid-October, after this present cycle is finished. I'll meet with Dr. Grapski two days later. By then, we'll have our first indications concerning the effectiveness of this treatment.
In the meantime, I'll be getting a blood transfusion this Saturday. My hemoglobin is at 8.8 g/dl -- "normal" is between 13.8 and 17.2 g/dl. A transfusion should push me up to around 11, then hopefully my body takes care of the rest. Why am I so low? I don't really know. I've been low (but not this low) since coming off the irinotecan/erbitux I'd been taking through the spring. I suppose the Xeloda takes out some...maybe the cancer in my bones is doing bad stuff, too. Plus, I was losing some blood due to those digestive/urinary tract infection issues I believe I'd mentioned. In combination, I suppose it's easy enough to believe my red cells would be low. Hopefully, a transfusion helps me out -- gives me more energy, helps the body recover a bit better, stuff like that.
Edit (9/21): I'd confused my hemoglobin with my hematocrit. The first is "the iron containing oxygen-transport metalloprotein in the red blood cells", and is quantified by mass per volume of blood. The second is a "measure of the proportion of blood volume occupied by red blood cells" and is reported as a percent. For men, it is typically between 38% and 52%. My hemoglobin is at 8.8 g/dl. I don't recall the hematocrit...but when I've needed a transfusion in the past, it's been around 24% to 27%.
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4 comments:
Did the hematocrit fall within a short period of time as far as you can tell or was it gradual? Does the reticulocyte count give any indications about the origin?
I haven't been paying as much attention lately to where my blood levels have been...I'll have to get that info next time I go in. So I can't say anything about how much the baby red cells (reticulocytes) are lacking versus anything else. If they are, this would be a stronger indicator that the tumors in my bones are causing havoc.
Having had a little time to consider...without looking at the measurements, I can guess that the drop in my red cell count has been fairly gradual. It happened so slowly that I hardly realized it, but I have to admit that lately I've been extraordinarily tired during the day and into the evenings. I'll get home in the evening and have a light snack while trying to do some reading on my deck. I'll find myself falling asleep -- sitting upright, outside -- within a paragraph or two. It's been this way for something like a month, but like I say, it came on slowly, and I could blame it somewhat on the increase in my pain killers. By now, I suspect my fatigue can't be blamed entirely on them.
You must have had your transfusion by now. Has it helped? I assume you've also discussed rhEPO with your doctors; any thoughts on that? Just anemia by itself can make a person feel crappy so it seems to me that getting the RBCs into the normal range is an important thing?
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