Thursday, July 2, 2009

A Chemotherapy Speed Bump

The goal of chemotherapy for me at this point is to kill enough of the cancerous blood plasma cells to make stem cell transplantation feasible. This "induction therapy" is currently scheduled to last for three or four "cycles", each cycle lasting four weeks.

Typically, the core drugs used in induction therapy are the steroid dexamethasone, which I have actually already been taking continuously since my first day in the hospital, in varying quantities; plus one of Thalomid, Revlimid, or Velcade. I was aware that the oncologist intended for me to use Thalomid; but I was unaware, until recently, that one of the major possible side effects of Thalomid is peripheral neuropathy, which involves numbness and/or tingling in the hands and feet. Given that I am already struggling with numbness in the feet, this possibility seemed unacceptable to me, so I pushed back on Thalomid. So now I am to be given Revlimid instead.

All well and good, except that this switch cannot be made instantly. One does not walk into the corner pharmacy and walk out with a bottle of one of these drugs. Their manufacturers make them available only via restricted programs involving specialized pharmacies that dispense them in single-cycle quantities only; the consumer must sign legal documents agreeing to many things regarding their usage. Given the Independence Day holiday weekend, the process of beginning to make the switch will have to wait until Monday. So for now I continue to be in a holding pattern.

There is a possible future post that could tie this in with the subject of health care costs. These drugs are very expensive. A single cycle's worth of Revlimid is probably in the range of $5000-$6000, as near as I can make out at this point.


  1. Test comment from yours truly...

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