Puddles ~ Leukemia

Garry took Puddles Friday to his Oncology appointment.
Puddles saw Dr. Parfitt and Garry really liked her,
said she spoke where he could understand her.

Puddles has B-cell lymphocytic leukemia which can be treated.
Since Puddles has been acting great, Garry asked if we can delay
starting him on any meds (didn't want to make him sick).
Dr Parfitt said if we didn't start him on meds now that in
3 months he would be much worse.  She wants to start him on
Prednisone (3 mth) and Chlorambucil (cancer drug) for 2 years.

Once Puddles starts on the meds he will have lab work once a
month and then see Dr Parfitt in 3 months.

We will start Puddles on the meds, but if he gets really
sick they will be stopped. Not going to let him suffer !

I have confidence in the doctors and the office is really high tech,
they even have a MRI machine (truck) out back like the
human hospitals have.

Dr Parfitt emailed us her discharge summary (2 pages),
which is really nice. Below are her recommendations.

      ****************************

Recommendations:  (copied from her email)

 

Puddles has been diagnosed with chronic lymphocytic leukemia (CLL). This is a cancer that

originates from an expansion of malignant lymphocytes (white blood cells). These cells can
circulate anywhere within the body. This disease tends to be slowly progressive and determining
at what point treatment should be started remains controversial. It is generally accepted that when
the lymphocyte count exceeds 60,000, when lymph nodes or internal organs or enlarged, or when
patients have cytopenias (low red cells or platelets), that treatment should be instituted. Puddles is
anemic and therefore I am recommending that treatment be started. Left untreated, this cancer
can cause damage to the normal bone marrow cells resulting in anemia (weakness, lethargy),
thrombocytopenia (bleeding), or leukopenia (infection). CLL is considered a highly treatable
disease, however most patients will require long-term treatment. The treatment of choice for this
disease is the combination of the steroid Prednisone and the oral chemotherapy drug
Chlorambucil. This chemo protocol is generally very well tolerated - side effects such as vomiting
and diarrhea are quite uncommon. Long-term the Chlorambucil can affect the bone marrow and
for this reason regular bloodwork monitoring is important. Because this disease tends to be slowly
progressive, reported survival times for patients treated for this disease range from 1-3 years.
We will call in prescriptions for Puddles's medications and they can be started next week. As we discussed today, the Chlorambucil is currently on limited availability, so we may have to make some changes to the pharmacy from where it is prescribed and there may be some changes in the cost for the drug (could range from $30-150 per month depending on the pharmacy). The Prednisone is a very inexpensive drug.


~ Cheryl ~