Cancer Part 4 - Chemotherapy and the Scary Day

After my surgery in February 1999, they determined that the chemo had basically done nothing. I had undergone months of hell and the chemo had killed less than 20% of the tumor. In terms of fighting cancer, anything less than 90% is deemed to have been ineffective. Needless to say we were discouraged at best. I will get into my surgeries in another post as well, but after I recovered from that surgery, the chemo started all over again.

They changed up my drugs this time. My next round of chemo started on Tuesday March 2nd and this time it would be 4-5 days in the hospital straight, no return trip home in between. The new meds were adriamycin, as before, along with ifosfamide and methotrexate.

I was always getting high doses of the chemo drugs, but that was about to get ratcheted up. The adriamycin would be administered as a drip (instead of a push as before) over a couple of days, then a full day IV drip of ifosfamide. The last would be methotrexate. The amount of that drug would be 10 times the lethal dose for someone of my size. I would therefore be given an antidote along with the drug to keep it from destroying my digestive tract along with the tumor.

I was only able to undergo 2 treatments with methotrexate. My body did not metabolize it. I spent about 6 days in the hospital taking the antidote with blood analysis for the level of the drug in my system every 6 hours or so. They poked my arm so much it developed scar material inside and they had to start poking me somewhere else.

On April 13, 1999 they told us they were discontinuing the methotrexate. It was causing damage to my kidneys. Not long after, they discontinued the adriamycin as well. It was causing heart damage.

The most ironic thing is that twice I nearly died, and both times were caused by the chemo, not the cancer. Once was at Christmas time in 1998. The other was the summer of 1999.

On Thursday, June 10th, 1999 Glynna wrote the following in her journal:

Chad nearly died Monday night. Chad had been in intensive care (ICU) all week due to his low blood pressure (49/16) and difficulty breathing. He is improving, but recovery is slow.

I almost died on Monday, June 7th. Over the weekend I had been experiencing a lot of pain in my chest and difficulty breathing. Saturday night I started coughing up blood and I had a fever. We called my doctor and he told me to take something for the fever and get some rest and see how I felt Monday. Sunday I was very lethargic, and early Monday morning I woke up because every breath was a new experience in pain.

Glynna called my doctor and he told us to get to the hospital. Of course, knowing now how close to death I was, we know we should have called 911, but at the time I had been through so much that we thought it was just another thing. Glynna called my dad to come take me to the hospital so she could stay with the kids and we tried to get me out to the living room.

I could not stand up without passing out. I crawled, with Glynna pulling on me, into the living room. I was sitting on the couch, nearly unconscious when my dad arrived. Glynna and my dad tried to carry me to the car, but I ended up crawling the last few feet. I could not stand up. At the ER, they brought out a gurney and a couple of guys helped me get onto it.

I do not remember much from that morning.

I remember someone holding me up against an x-ray machine because I could not sit up enough for them to x-ray my chest since I passed out so easily. I remember about 6 or 8 people rushing around in the ER room, putting in IVs into the back of my hand (OUCH! worst place for an IV), talking to my dad, taking my blood pressure. Before I knew it I was taken up to a room.

It was not long before my doctor arrived and looked me over. He immediately sent me to the ICU. I remmeber vaguely being wheeled into the ICU room, then it all goes blank. For the next 3 days or so.

I understand that night they told Glynna that I would probably not survive the night, that she should go be with me for a bit one last time just in case. I don't remember any of that, and I am glad that I don't. I can't imagine what it would have been like to go home to your 3 small children, trying to figure out how to tell them their daddy died last night. Sorry for the melo-drama, but that is what hits me when I think about what that night must have been like for her.

I had pneumonia, brought on by the destruction of my immune system by the chemo. The chemo had greatly suppressed my bone marrow, which means my body had stopped producing white blood cells, which fight infection. Bone marrow also replenishes your blood supply. Your body replaces your blood supply every few weeks, and your blood cells naturally die off and are replaced in that time period. Since my bone marrow was basically dormant due to the effects of the chemo, it could not replace the missing red blood cells. Also, I was partially dehydrated, so that meant my blood fluid level (plasma) was very low. They doubted I could fight off the infection, and even with transfusions they thought I would not be able to last long enough for my body to start to support itself. Luckily, this was one of the miracles we witnessed as part of my battle with cancer.

As of June 12th my blood pressure had improved to 98/42. If you don't already know, normal blood pressure is usually somewhere around 120/70 give or take. 49/16 is barely readable on blood pressure instruments.

I would spend 9 days in the hospital. At the end, I was begging them to let me go home. Being in the hospital is bad, not because you are sick, but because it is BORING. More boring than you can imagine. Math class boring. Long lines at the DMV boring. Only worse. You can only watch so much TV and read so much and play so many mindless games (I must admit however that a little hand-held monopoly game really saved my sanity quite a bit during that year), until you are ready to pop.

My monopoly game.

After that my chemo was done. They had given me, literally, MORE than what should have been my lifetime limit for more than one chemo drug. The adriamycin in fact they continued past the point of my lifetime limit, giving me a dose, then giving me an EKG to ensure my heart was not yet damaged, then another dose of chemo. This continued until the EKG showed damage to my heart, then they stopped. The methotrexate I could never use again as my body could not handle it and it damaged my kidneys. I was done with chemo, probably forever since there were several drugs I could never have again. Hopefully, I will never need them.

I went in for some follow-up scans to see what if anything was left of the tumor. Standard scans like MRI and CAT scans showed nothing, but they did a couple of other scans to look for the tumor in ways the CAT and MRI scans cannot.

Both of the other scans are part of what they call nuclear scans. That is, they inject you with a radioactive isotope that then attaches itself to the tumor, and then they scan to see where the isotope collected. If there is tumor remaining it will give them a "hot spot" on the scan.

First, I underwent a PET scan. That is a postitron emission tomography scan. Here is a picture of a PET scanner.


A pet scan is done by injecting a radioactive glucose solution (glucose molecules attached to a radioactive isotope) into a vein. You then lay quietly for an hour. Then they put you in the machine. The idea is that your organs use glucose at different rates. By lying very still you allow the glucose to be absorbed by the organs that use it the most at rest. This includes your brain, heart, and liver...as well as cancerous tumors. Since tumors are typically growing at a rate faster than any other organs in your body, they will use more of the glucose. You are then scanned by a device that can "see" the radioactive isotope that was attached to the glucose, which can then give you a picture of the active parts of your body, which includes tumor material.

The results of the PET scan were negative, there was negligible tumor material remaining. It was about what they thought it would be. The tumor was not completely eradicated, but what remained was less than they thought would be there.

This was followed up by a bone scan, which is similar to a PET scan, but uses an isotope that is designed to attach itself to bone material, so they can see if any of my tumor picked up the isotope, since what I had was a bone cancer tumor. This was mostly to look for metastasis, or migration of the cancer to other parts of the body. This also came back negative.

So far, so good.

Since the scans came out ok, the next step was what to do with the remaining tumor. It was decided to send me to Loma Linda University for Proton Therapy, and that will be the subject of a future post.

Next posts: Surgeries and Proton Therapy.