Apple Sauce, Toxin and Blue Sprinkles

It feels diabolical. Before you break the capsule, you have to put on latex gloves. The contents are toxic. When it splits open, the poison snows out in a powdery dust that quickly disappears into a marsh of apple sauce. The best way to conceal any hint of the drug’s bitter taste is to throw in a dash of candy sprinkles. Once added, the mixture stains from pale yellow to electric blue. Although it’s a doctor-prescribed treatment, the scene plays out like a chapter from a dime-store crime novel – scheming in the kitchen, a twisted, deranged parent poisons an evening snack to quietly finish off a child. But this is a different sort of master plan. It is Jordan’s nightly dose of healing, a chemotherapy dessert.

The drug is Temozolomide, approved by the FDA in August, 1999. Sold by Schering under the brand name Temodar, it is specifically designed to treat patients with certain forms of brain cancer. It is administered orally and it acts on DNA in the cells of the body to affect cellular growth, suffocating cancer cells while passing over normal cells. You may never have heard of Temodar before, but thousands of children with astrocytomic brain tumors are regaining health thanks to its innovative design. In a recent study reported in the Journal of Clinical Oncology, 61% of patients responded to treatment with the drug, and few patients showed any signs of toxicity. (FYI – Jordan’s oncologist is a co-author of the study.)

The true beauty of Temodar is its relatively low incidence of side-effects. It usually does not cause hair-loss. Nausea, another common by-product of chemotherapy, is also rare. But this drug, like all drugs, comes with risk. Chemotherapy can take a toll on the body’s immune system. That’s why Jordan returns to the hospital every two weeks for lab work and exams. The doctors look for any signs that her immune system might be weakening, paying close attention to her white blood cell count. I’m happy to report that Jordan’s Irish blood seems more than fit for the challenge of toxic drugs. She is half-way through her first chemo cycle and her blood counts are robust.

Only time will tell whether or not Temodar will reverse Jordan’s cancer. The doctors advise patience. They warn us not to be discouraged if we see further tumor growth in the months ahead. Temodar works slowly. We’ll monitor her progress in follow up MRI scans, the next one scheduled a few days before Christmas, but no one expects to see much change then.

Think of Jordan’s story like a slow-moving war epic. Inside her body, three armies engage on a sprawling battlefield. The army of cancer slowly and methodically usurps innocent tissue, while a rebel army of insurgent white blood cells and a band of mercenary Temodar troops join forces to stop the invaders. The allies are an unlikely pair. Like Celtic tribes of old, they sometimes knock one another off, but their combined strength is indeed a powerful resistance. Progress is not always apparent on the battleground, but the proof rests in the smile of the precocious child on the outside, crunching sprinkles in her apple sauce.

Now for the plug: Temodar is one of many drugs made possible by ongoing clinical research. As the holiday season approaches, please join us in contributing to the efforts of researchers all over the world. Private funding from organizations like the Lance Armstrong Foundation and St. Jude Children’s Research Hospital make advances in cancer treatment possible. You can help, too, by giving them your support.