Two Lucky

There are two numbers that doctors watch before approving each additional dose of IL-2: The patient’s blood pressure and urine output.

One critical side effect of IL-2 is that it can cause blood pressure to fall quickly and - if it is too low - lead to decreased blood supply to the brain, causing dizziness, weakness and fainting.

Another is kidney failure, which is why the hospital checks if the patient is peeing. Part of the urinary system, the kidneys filter waste and excrete them, along with water, as urine. When the kidneys stop working, there’s no urine.

By 10am - almost 14 hours after his sixth dose last night - Rusty’s BP had fallen to 70 mmHg, and there was no urine to collect. His liver and kidneys were beginning to falter. He was unable to sit up. He had also become very confused. “Why aren’t we home? I don’t know what’s going on,” he said to me, fighting back tears.

The doctors decided it was time to stop.

Even though we were disappointed, there were encouraging words from the doctors and nurses who dropped in to check on Rusty.

In the last three years, only two people have completed the full 15 doses. According to our nurse, the chemotherapy floor sees about five or six patients for IL-2 every week. That’s two out of potentially 780 patients, which works out to be 0.25 per cent of patients who withstood the entire treatment course.

Most healthy, adult patients average seven or eight doses.

Also, from Dr Taback, one of our treating physicians: “I think you’re done very well. You’ve exceeded the whole team’s expectations. Due to your condition, we were very hesitant about treating you in the first place. It was a risky call. We didn’t think you’d be able to tolerate more than one or two doses, three max.

“Now it’s time for you to get better.”

Unlike standard chemotherapy, IL-2 patients tend to bounce back faster. The side effects from the drug typically wear off in 24 hours. The hospital staff will continue to monitor Rusty during this time. If his numbers are good, we go home tomorrow.

This entry was posted on Sunday, February 11th, 2007 at 11:57 am and is filed under New York, Melanoma. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.