Irinotecan.
These are two names my wife and I will become very familiar with over the next year. These are the first two drugs Elle is being given in her treatment cycle. Or, to look at it another way, these are the first two poisons my daughter is being given to kill off a deadlier poison in her body.
Let's not dance around this; these are powerful chemicals and in an ideal world, no one would ever have to take them. They attack healthy cells as well as the cancer cells. And they have side effects. Which is why the nurses where protective gowns and face-shields when they give Elle the liquids. And why her diapers are disposed of in a hazardous waste bin.
That said, kids respond differently to chemo drugs than adults. They are tougher than adults. Whether that is because they don't know any better and live in the moment or they are physically stronger when it comes to chemo tolerance isn't known. But the truth is that if you or I took this stuff, we'd be a much bigger mess.
And she is okay right now. The nurse said that we wouldn't see any possible side-effects until tomorrow at the earliest. And that it would likely be nausea, which is easily treated with an anti-nausea medication.
Elle was up and walking again today. The big news aside from the chemo is that her chest tube may come out tomorrow. If that happens then she'll likely be home by Monday. She looks good and sounds good, chatting up a storm as she always does. And that has baffled the doctors to some extent. She looks a lot better than someone with a tumor on their right lung should look.
You may want to know what these two drugs do. Vincristine disrupts cellular production by halting mitosis in metaphase, so it is supposed to stop the growth of her cancer. Irinotecan does the same thing but targets the DNA of the tumor. It's a relatively new drug, coming to the US only in the mid 1990s. Recent studies suggest that starting Irinotecan at the outset of chemo (it usually comes in later during the process) would be beneficial to fighting the cancer. So when they presented it as an option, we agreed with it. Both of these drugs attack the tumor, but also impact white blood cell production and, classically, hair growth.
That isn't guaranteed to happen to Ellie, but it likely will. Which works out alright since she isn't fond of her hair right now. Sadly for all of you, if she does lose her hair then I am shaving my massive dome. That will not be a pretty sight.
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