Moving forward with Chemo -- (What are they putting in Stephanie's body???)

With all of the complications from surgery and extra procedures, we have not had much time to speak or even think about treating her overall disease.  This past week's doctor visits were the first steps toward aggressive treatment for the cancer.  Sometime this week she will begin the process of chemotherapy.

Because of the plumbing issues caused by Stephanie's 'debulking' surgery, she will have to delay the most important treatments of intraperitoneal chemotherapy (IP chemo) until after they are fixed and healed.  For those that aren't familiar with IP Chemo or Chemo in general, I will provide a quick lesson.  (Both Stephanie and I knew almost nothing about this topic 4 weeks ago and we are still learning every day.)

First, it helps to understand that there are two different methods of chemotherapy used to treat Steph's type of ovarian cancer (low-grade serous adenocarcinoma).  

1. The first method is the more traditional where they give the chemo drug intravenously where it enters the blood stream and attacks cells through that body system.  
2. The other, less traditional method to treat ovarian cancer, is called IP chemo.  It derives its name from the peritoneal fluid that bathes the abdomen and essentially your guts.  It is a fluid that (I'm sure) has many functions but one of them is to ensure that your guts are lubricated.  Ovarian cancer can spread microscopically through this intraperitoneal fluid to other organs within the abdomen.  IP chemo is given through a port directly into the abdomen and it mixes with the peritoneal fluid and works to kill cancer cells present in the abdomen.  
3. Chemo therapy is given in many doses and the treatment can span several months.  In Stephanie’s case, she will receive treatment for somewhere between 4 and 6 months (I think).

Second, it helps to understand how chemo works.  (The layman's perspective)

1. Cancer cells are generally known to grow more rapidly than most normal cells in your body.    Someone smarter than me figured out that chemo actually attacks cells that grow very rapidly (like cancer) and serves to kill the cells at replication.  Therefore, chemotherapy is a treatment that targets the disease on a cellular level.
2. There are also some good cells that grow rapidly in the body that are attacked by chemo therapy. Unfortunately, chemo treatment does not discriminate and it attacks and kills cells both good and bad.  This is the primary reason chemo patients lose their hair and their immune systems are weakened during treatment as white blood cells and hair cells grow rapidly.  Attacking both good and bad cells is one of the primary reasons chemo patients become so ill and fatigued.  

Finally, there are (probably) hundreds of types of chemotherapy.  Stephanie will begin her treatment with two chemotherapy drugs applied in what is called a ‘dose dense’ regimen.

1. Carboplatin - This is a veteran of chemo drugs that is used to fight several types of cancer included Ovarian.  It can be used in IV and intraperitoneal treatments and it is ultimately derived from the metal platinum.
2. Taxol - This drug is given through IV and is used to treat several different types of cancer.  It was originally derived from tree bark but is now produced synthetically.  
3. Dose Dense - This refers to the method and frequency of chemo treatment.  As chemo treatment has evolved and improved, physicians have learned that it often is better to administer chemo at more frequent rates.  Traditionally chemo was given in cycles (once every 3 weeks).  After learning that cancer cells are more susceptible to chemo at different stages / timeframes, the dose dense cycle was developed.  For Stephanie, this means she will receive chemo treatment weekly and will receive a combination of both carboplatin and Taxol during each session.  

Stephanie will begin her regimen of chemo on Friday, October 24.  As you can imagine, this is a scary process to willingly take drugs that will almost certainly make you ill.  Please continue to keep her in your thoughts and prayers as she begins this part of her battle.