Chemo #7: Surprise!

Corrections and additions in bold.
Yesterday (Thursday) was chemo infusion session number 7.  This is the first one that had been scheduled on the 3-week interval basis.  Thus, we took ourselves down to Bellingham with full confidence that Ed's lab values would be exquisitely appropriate.  And then, when they actually did the blood testing, we found to our surprise that the white blood cell/neutrophil count was very low; too low for chemo.  Its actual number was  .8  [.7].  It must be at least 1.0 for chemo.

The new plan was to give Ed an injection of Neupogen.  This name makes it sound as if this is a drug that you get to make you stupid, but it is instead a very expensive ($1,000 per injection, covered by Medicare but only if a nurse gives you the injection as opposed to your doing it yourself) drug that gives strict instructions to your bone marrow to get to producing white blood cells, particularly neutrophils, immediately, and it's not kidding.  The downside of the injection (other than the cost to someone) is occasionally pain of an occasional sort in the sternum and/or hip.

So, the nurse gave the drug and we drove back to Point Roberts and Ed had an occasional slight pain in his sternum and hip throughout the evening, and Friday morning we drove back to Bellingham for a new set of blood tests.  Does the Neupogen work?  From .8 on Thursday at 1 p.m. to 9.8 [9.0] on Friday at 9:30 a.m.  That's results.  The normal neutrophil range is 2.2-4.8, so you have to think that there's a little overshooting.  But the ensuing chemotherapy doubtless got rid of any extra neutrophils anyway.

So, all in all, a good day.  The most recent CEA number was 5.4.  Normal people without cancer have readings of 1.0-3.0.  Wikipedia offers this information about CEA:

An example of a cancer-specific marker, CEA, or carcinoembryonic antigen, is a blood-borne protein, first noted to be produced by tumors of the gastrointestinal system. . . . However, in a patient with a history of a treated bowel cancer, a rising CEA level can be an early sign of recurring bowel cancer. This usually occurs before the site of return can be identified on imaging or examination and so many oncologists question the wisdom of doing a blood test for CEA when the end result is bad news that alarms the patient. Nevertheless, a sequence of steady low CEA readings can provide much needed reassurance to the post-operative patient.

So, we are reassured. Even as we are assured that the CEA reading is not entirely reliable although its direction (down in this case) is a good sign. And the 7th chemo is finished.  And on Tuesday just past, Ed completed the second round of coastal Point Roberts photography in the R22 helicopter.

Shelly asks about prior CEA levels: 
Feb. 293.6
April 96.7
May 40
May 25
June 12.2
July 5.4