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Some women who have recurrent breast cancer, despite chemotherapy and radiation therapy, may wish to pursue the most aggressive treatment options available. This decision is very personal and involves issues such as current "quality of life" versus the hope of a cure with extreme treatment.
The goal of this part of the treatment is to kill all the cancer cells in your body. Your remaining bone marrow is also affected by this chemotherapy. You are monitored closely in the hospital by a team of expert treatment specialists. Later, the healthy bone marrow that was harvested is transplanted back into your body (through your bloodstream) and is used to "rescue" you after the high doses of chemotherapy.
The bone marrow cells can be harvested from you in two ways, depending on the type of transplant being done. One method involves a one-time visit to the operating room, where you are given general anesthesia and the doctors remove the marrow by placing needles into the hip bone and withdrawing some of the bone marrow. This entire procedure takes one to two hours. You will be awake and alert in the evening of the same day. There will be some soreness, but pain medication will be given if needed.
The other method collects bone marrow cells from the circulating blood system. This procedure is similar to having blood drawn, and the only discomfort the donor may feel is when the needles are inserted. This is done on an outpatient basis. Usually three to five procedures are needed to get enough cells for a transplant.
So the day I was there for this visit, the initial visit, they did a bone marrow biopsy and that's to be sure that there are no cancer cells in the bone marrow. That was done right there with local anesthetic. It was very painful. They go into the bones in your hips in the back on both sides with a long hollow needle, and they have to draw out bone marrow to do slides and so forth. Anesthetize so much, and then once they get into the bone it's a very painful thing to have done, but fortunately, it doesn't last all that long.
In an otologous bone marrow transplant you are using your own bone marrow so to speak instead of getting a donor. What they do is they collect stem cells. And stem cells are a certain type of white blood cell that's actually called a parent cell because the stem cells create all the other blood cells. They create the white blood cells, the red blood cells, and the platelets are all created from stem cells. And of course, those are all the things that make up your bone marrow. So what they need to do is collect these stem cells, and this is done through a procedure called aforesus, that's the collecting of the stem cells. And to prepare you for this and during the time that you're going through it, you take high doses of a drug. And this is a fairly new drug on the market which increases the white cell count. It is used in patients going through chemotherapy when their white cell count gets real, real low and they become ill and have side effects. You can get shots of this to bring your white cell count back up. But this drug has been especially effective in this type of bone marrow transplant to help produce new white cells.
I don't even remember a lot about those four days. It was not a pleasant time. They used three chemotherapy drugs and you get 10-20 times the normal dose, and it's a continuous dose for four days. I was absolutely terrified of this high dose chemotherapy, very frightened of, you know, nausea, and vomiting. They have drugs to control those side effects that were much stronger than anything I had been given going through standard chemotherapy. One of the drugs, called, not only does it control the nausea and vomiting, but it makes you very sleepy. And I was on that almost continuously. It was a foggy time.
They give your body three days to rest and on the third day, you are transplanted. This is a very exciting time. They are literally giving you your life back. They bring you to the brink and then they save you by giving you back your own stem cells that they froze. They brought all these little packets of frozen cells into the room, and these are thawed out in the room, and the steam rises up. It's all very mystical. They go into your body through the IV that you're already hooked up to. These stem cells, it's like they have little magnets and they know to go right to the bone marrow. They tell you it could be 10-15 days before you start showing any cell counts. During that time you have no way to fight infection. You can't even fight viruses or any bacteria that already exist in your body. So, they expect you to run fevers and get infections. Most of the time, those can be controlled with antibiotics.
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During the process of a bone marrow transplant, you are given extremely powerful doses of chemotherapy. Normal chemotherapy uses anti-cancer drugs to kill the cancer in your body. The use of very strong anti-cancer drugs for this procedure also starts to destroy your bone marrow. However, in a bone marrow transplant, you donate healthy bone marrow before the chemotherapy begins. This is called harvesting, and the cells are stored for later use. Then, very strong antiÐcancer drugs are used (up to 10 times as strong as normal chemotherapy), often making you weak and susceptible to infection.up to Contents of this Page
Bone marrow itself is the sponge-like tissue found inside your large bones, and makes the blood cells in your body. This cell-making function of bone-marrow is essential to your body's vital functions and your body's ability to fight infection, so any changes to your bone marrow require extreme caution.up to Contents of this Page
Maggie's experiences
