24-03-2006 Blood test results

[dadmo]

Al:
Take comfort from the fact that your doctors appear to be giving you the correct treatment. You would be surprised how many don't.

[Alucard]

Yeah. I just came back from the hospital and I had a CBC done and they said I couldn't have the bleomycin (I'm assuming that's what I was going to have) because my blood count came back as too low so it was delayed until this monday. I asked then what could I do and they said I should eat well and stay away from ill people so that's what I'm gonna do.

-Al

[Jens]

Hi Al.

I'm a little concerned about your bleomycin beeing postponed again. How far into the treatment are you? If this is the final series it's OK, but you just started you may need a boost of some kind.

Best wishes
Jens

[Alucard]

Hi,

So far I had the first 5 days of chemotherapy, straight (I had bleomycin the first day) and then I had another bleomycin shot after 3 days.. Then I was supposed to wait a week until the next bleomycin shot so then I went there and they postponed it and you know the rest so I guess I had one full session, counting the bleomycin shot I'm going to have monday, if I have it?

I'm a little bit confused.. I think they said I was going to have 5 days of chemotherapy, rest 3 and then another five but they told me I was only going to have it again after a visit to the doctor.. so I don't know if this whole thing was 1 one the 3 sessions. I'm going to ask him this tuesday.

I don't think I'm making any sense so I'm going to stop writting now.

Regards,

-Al

[Jens]

Hi Al.

You make perfect sense, you just need some info.

BEP is given in 3 week series.

Week 1 is 3 or 5 days of Etoposide and cisPaltin, and in one of the days also Bleomycin.
Week 2 is one day of Bleomycin
Week 3 is one day of Bleomycin.

This is one series of BEP.

Or put like this (the 3 days version)
1. series
day 1: EP
day 2: BEP
day 3: E
day 9: B
day 16:B

2. series
day 1 (or 22): EP
day 2 (or 23): BEP
day 3 (or 24): E
day 9 (or 30): B
day 16 (or 37): B

and so on..


5 day version:
1. series
day 1: EP
day 2: EP
day 3: BEP
day 4: EP
day 5: E
day 9: B
day 16: B

and so on again...

Normally 3 series (3xBEP = 9 weeks in all) is given, but as you are stage III 4 series may be the right choice.

If you are getting a different treatment, you should react promptly!

Best wishes
Jens

[TSX]

5 day version:
1. series
day 1: EP
day 2: EP
day 3: BEP
day 4: EP
day 5: E
day 9: B
day 16: B

and so on again...

Normally 3 series (3xBEP = 9 weeks in all) is given, but as you are stage III 4 series may be the right choice.

I think 3xBEP or 4xEP is standard for stage II bulky seminoma or any stage II nonseminoma, and 4xBEP is standard for stage III, right?

By the way, my 3xBEP protocol is slightly different from what you have listed above:

day 1,22,43: EP
day 2,23,44: BEP
day 3,24,45: EP
day 4,25,46: EP
day 5,26,47: EP
day 8,29,50: B
day 15,36,57: B

The only difference is that I get cisplatin over five days, where your listed protocol has it being given over four days. Also, my bleomycin during the second and third weeks of each cycle is moved up by one day to coincide with my oncologist's office hours, such that she can check my blood test results and monitor my breathing prior to giving the OK for the bleo each of those days. I also get a full pulmonary function test at the start of each 21-day cycle, and those results factor into whether to continue with the bleo or not. I was told that adjusting bleo by one day on the second and third weeks of each cycle would not make a difference in the efficacy of the treatment.

I also got a shot of Neulasta on day 6 and day 27 to avoid low WBC problems. Today is day 30 for me, so just over halfway there. The EP days are the worst for me, and those are 2/3 over at this point.

-TSX