We talk alot about side effects within these "pages," but in many respects they are just as important as the front effects (the actual treatment). I seem to learn something new about cancer THERAPY every time I go to the clinic, so I thought I'd share this little (actually significant) gem with you.
Managing the side effects of any single or combination of chemotherapy medications is as much a part of the process as the actual use of the drug itself. In the early years of chemo treatment, doctors were not indifferent to the adverse reactions that patients would have, but they were less knowledgeable or aware of how to deal with them. The sophistication of that understanding has increased dramatically over the years, and in some cases, it's as much (if not more) important to control the side effects as it is to control the dosing and administration of the chemo. You see it sort of works on a formula: the more that you can manage the side effects, the higher the dose that can be used, or the greater the variety of options that can be offered - and then ultimately the higher the success rate for cancer treatment.
I have had this experience in my own course of therapy, and am living with that right now. As we know, Multiple Myeloma is never really defeated, and those pesky myeloma cells constantly try to keep multiplying. The stem cell transplant that I had sought to take their count down to zero, but that's not attainable (yet), so over time (relapse duration as of yet undetermined; but counted in years), the reproduction of myeloma cells increases. My variety of maintenance drugs seek to keep that escalation in check - or as low as possible. But already that number has begun to rise on occasion (for perspective: when diagnosed I was at 7,000+ and now I am under 1). As the numbers recently began to rise (around 20), Dr. S. and team decided to start introducing stronger maintenance drugs to address this small but noteworthy increase. He tried one drug, which I was able to tolerate (ie: handle the side effects) but it didn't work. Always starting with the least powerful drugs, but hoping they will work, he stepped it up a notch. I was able to handle drug #2, (again no side effects), but still wasn't getting the results he desired. But it encouraged him to try drug #3 (stronger still, with its own side effects). I was able to tolerate that one and it has beat back the advancing myeloma cells (back down under 1).
So that process of using increasingly stronger chemotherapy drugs, ones whose side effects I could tolerate, allowed him to explore a broad arsenal of weapons and find the right balance of a myeloma cell production controlling REGIMEN, that I was also able to handle its side effects (quality of healing + quality of life). You see, the goal is not to make me as sick as possible in the course of therapy, but to make me as healthy as possible - while maintaining the most effective remedy. Less side effects means more treatment choices or higher dosage options. Better living through chemistry.
