Page 61 of Missed Notes (Rixon High 5)

“Okay.” Dad shifted uncomfortably. “What does that mean for treatment?”

“Well, we have a few options and at this point, I’d like to invite Dr. Jeffries in if that’s okay with you. He’s one of our senior oncologists and he’ll be taking over Sofia’s care going forward.”

“Of course,” Mom said.

Dr. Peters rang his secretary and a few seconds later, a tall, black man with kind eyes walked into the room.

“Hello, I’m Dr. Jeffries. You must be Sofia and Mr. and Mrs. Bennet.”

“It’s nice to meet you.” Dad stood, offering the man his hand.

“Has Dr. Peters explained things to you?”

“Yes, but I’ll be honest, Doc, it’s a lot to take in.”

“Of course. I completely understand. We’ll throw a lot of big scary words at you over the coming days and weeks, but the most important thing to remember is, we have Sofia’s best interests at heart, and we’ll do everything we can to help her fight this.”

“Mr. Bennet is keen to know the treatment options, John. If you’d like to take the lead.”

“Of course.” He sat in the chair off to the side. “Typically, in the treatment of adolescent CML we use something call TKIs or tyrosine kinase inhibitors. The drugs come in tablet form and in simple terms, they identify and attack specific types of cancer cells while causing less damage to normal cells.”

“What are the side effects?”

“Nausea, vomiting and diarrhea, muscle cramps, fatigue, skin rashes. Some patients experience a plethora of side effects, others find them to be very mild and manageable with over-the-counter medication. At this stage, it’s impossible to tell.”

A violent shudder went through me.

“Sofia, do you have any questions?” Dr. Jeffries asked me.

“I… Will I be able to continue going to school?”

“Again, that’s something that I don’t have a hard and fast answer for.”

“Will the TKI drugs cure it?” Mom asked, and his expression turned somber.

“No. Leukemia, like many cancers, is incurable. However, with the right treatment, prognosis is usually good and lots of patients go on to lead healthy lives.”

“Okay,” Dad murmured, squeezing my hand. But I couldn’t look at him. I couldn’t look at anyone really. Because if I did, if I saw the fear in their eyes, or the sympathy in the doctors’ eyes, I would lose my thin grip of control.

Incurable.

That didn’t sound good. Even if he was talking about good prognosis and success rates.

“What happens if Sofia doesn’t respond well to the TKI inhibitors?”

“There are other treatment options available, or we can look for a donor match. Stem cell transplants isn’t a first route of treatment for CML, but it has proven to be successful in a lot of adolescent cases.”

“Shouldn’t we just do that now? If it has a good success rate?”

“The surgery requires the cancer to be in remission, or at least, under control. Which means either chemo or the TKI route. We’ll monitor Sofia closely, see how the cancer responds to the TKI therapy, and go from there.

“I know it’s very scary, and I know that you probably won’t absorb everything we’ve discussed today, but I want you to know that in most presentations of CML, young patients usually respond well to treatment.”

He launched into another lengthy speech about treatment statistics and outcomes, but I zoned out until Mom said, “And what about her fertility?”

“Mom,” I gasped, heat flooding my cheeks.

“Your mom is right to ask, Sofia.” Dr. Jeffries smiled again. “Starting a family might not be on your radar now, but you won’t be eighteen forever. The data on the impact of TKI therapy on fertility is still emerging. Given your age, it’s something I recommend you discuss with your parents before we start your treatment plan.

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