It’s Just Life After Cancer

Alex’s blood tests were ambiguous. They contained “immature cells”. For a kid who has come out of chemo for Acute Lymphocytic Leukemia, that is unsettling news. The lab said they’d get the results confirmed and clarified, and that we’d have to wait until they did. That was on Friday.

Of course, no one was in a hurry over the weekend. Had this been the relapse it very well could have been, the four days that it eventually took just to get the results back could have made a huge difference in his prognosis. Relapse is grim enough as it is, and delays make it worse.

We agonized over the weekend, and through Monday, calling to find out what the status was. We were finally informed on Tuesday afternoon, that he had “reactive cells”. This was their way of telling us that it was normal cells, but cells which are not normally found in the blood (they are normally confined to the marrow). There are three basic times when they come into the blood stream – when the body is reacting to an illness (generally a significant one such as flu or mono, or something else that you know they had), when the body has been subject to trauma, or when the body is stressed by a disease process (cancer can be one of those, or Crohn’s, or other serious but silent illnesses).

To our knowledge, Alex has none of those. His weight had also dropped significantly, and he is looking very skinny and losing strength, feeling fatigued and cranky. Nothing dramatic, but there, and worrisome. The very symptoms he had four years ago at initial diagnosis.

His other blood counts are not typical for a reaction that would normally accompany the presence of reactive cells – no atypical rise or fall in other blood counts. Just this one odd blip, and lymphyocytes on the high side of normal.

But this is, again, all part of living after treatment for cancer. You never see illness the same again. It is not a panicky feeling, though you do worry. And you know, as few parents do, the urgency of getting results in a timely manner. You watch for signs and indications that most parents never think twice about. And it will never go away. There is no known outside range at which B-cell Leukemias have a zero risk for relapsing. It gets less likely over time, but it never completely goes away. You learn to be vigilant – not overreactive, you just pay attention. Because it matters.

We learned things from this. That we were woefully unprepared financially for a crisis of this magnitude. That we are mentally well prepared – we knew within half an hour of the news, just how we would handle it if it were a relapse. We knew within days what our best treatment options would be, and how we’d handle the difficulties that could cause. We knew we’d be ok if it WERE a relapse.

And we learned that four days is far too long to wait for test results. We’ll be using a different lab from now on. One that can determine leukemic blast cells from myelocytes right away.

Alex goes back to the doctor in another week, for a repeat CBC and checkup, to see whether he is still in a decline, or whether he had something going on in the background that he is bouncing back from. So the worst worry is over, but a niggling one remains.

And it probably always will.