Andrea is at home and big decision ahead

Andrea was discharged from the hospital yesterday. She is at home in Indianapolis and recovering. She is still having pain in her back and vertigo. The pain is being controlled by pain medicine and hopefully over time the pain will subside. The doctors are trying some differents things for the vertigo to try and get that under better control. They are trying a scapalamine patch to see if that helps Andrea's vertigo. She did try that patch early on in her treatment and it was not effective. However, it is worth a shot now and so many things have changes since then that maybe now it may be more effective.

Additionally, the big decision that is weighing on Andrea's mind is whether she should receive more chemo or stop the treatment. Originally, the protocol that Andrea put on by Dr. Kent at Rush in Chicago was a treatment that had a near 90% cure rate and had a total of 9 chemo treatments. That protocol was and has been very intense and was only meant for patients up to the age of 21. There was not much data on its effectiveness on persons near Andrea's age, but Dr. Kent and all of us were hopeful that it would achieve the same 90% cure rate in Andrea.

However, due to its intensity and other factors, the treatment has been extremely hard on Andrea and even near fatal at times. Everytime Andrea has gotten chemo, she has had to be subsequently rushed to the hospital with an infection. Thus, the doctors at IU Medical have recommended that maybe stopping the treatment is the way to go to prevent any more near fatal incidents. Alternatively, even if additional chemo is not fatal, it may lessen Andrea's future quality of life greatly. For example, additional chemo may cause such an infection that she has be on a ventilator or make it so she simply cannot participate in the things she has always enjoyed - like gardening/being creative and other things.

Andrea still is going to have a conversation with Dr. Kent though to get his input and opinion on this issue. The downside of not receiving any more chemo is that it does not give Andrea the satisfaction of completing the protocol that she is on. She has completed 6 out of the 9 treatments. Also, it gives her less hope that her cure rate is in the 90% range. The doctors at IU have indicated that an adult who receives 6 rounds of chemo has a 50% cure rate. However, the three rounds of chemo that are left are called Maintenance Rounds and even Dr. Kent has stated that he doesn't know how necessary these rounds are to achieve the 90% cure rate. Thus, even if she stops, she still may be at a much higher cure rate than 50%. Also, Andrea in her 6 rounds of chemo has still received much more chemo at a much higher intensity than a normal adult who would receive 6 rounds of chemo.

There are other considerations to think of as well. One such consideration is Andrea's stem cells. If she were ever to relapse and needed a bone marrow transplant, she would need healthy stem cells for a transplant. However, right now, she does not have healthy enough stem cells to get a transplant. Thus, stopping chemo now would allow her stem cells to recover in order for her to receive a transplant. If she were to get more chemo and she relapses, she may not have had enough time to have her stem cells recover and would not be able to get a transplant.

Another consiration is that Andrea's bone marrow and immune system is extremely weak. The doctors have told us actually that there is more risk of relapse if her bone marrow stays suppressed for a long period time and if her immune system is weak. If she stops chemo now, it may allow her to recover and get healthy and strong to be better able to fight a possible relapse.

So, she has a great deal on her mind and great number of things to consider. Whatever she decides however, we are all behind her 100% and will always support her no matter what. She is very strong and she has and will beat this cancer no matter what she decides.