In 2008, Nancy White 赌博 learned that she had a rare form of leukemia called acute promyelocytic leukemia. APL，一种 急性髓性白血病在过去，这是一种难以控制的癌症. 幸运的是，今天它不仅可以治疗，而且可以治愈. 经过两年的治疗, 赌博, 现在59岁, got a clean bill of health and resumed her active charity work in the Napa Valley, 她住的地方.
你是怎么发现自己得了白血病的?
我是在2008年7月1日被确诊的. 几个星期以来我一直感觉不舒服. I had symptoms like fatigue, loss of appetite, mild fevers, a mild cough and achiness. 我一直在看我的初级保健十大赌博平台排行榜(在HMO). I was going in almost weekly, and he kept saying it's a viral syndrome. 但我并没有好转. 我就知道有事要发生.
我去看了另一个十大赌博平台排行榜不在医保组织, who said I should ask my primary care doctor to order blood tests. Then one day I was rinsing my mouth after brushing my teeth and a purplish, 黑色的血块流出来, 就是拔了牙才会看到的那种. It just so happened I had an appointment that day to see my primary care doctor. 所以我又告诉他我不舒服, 我一直呼吸急促，盗汗, 我知道这可能是由某种血癌引起的. 我问他:“你觉得我可能得了癌症吗??他说:“哦，不，你不用担心。.“但我让他做血液检查，他同意了.
我正开车回我在圣. 我的牙龈突然开始大量出血. I called my [non-HMO] doctor and he told me to come right over. 我一到他办公室就去了, he began packing my gums with gauze and called the HMO to get the results of my blood tests. 测试显示我的血小板数是一万两千.
很低吗??
哦,是的. 正常是14万左右. He said, "Nancy, you've got to get to the hospital immediately. 你需要输血." At the emergency room, the doctor told me I probably had leukemia. I was admitted and got a transfusion of platelets and then they did a bone marrow biopsy, 证明我确实得了白血病.
那时候你知道它是APL吗?
我们花了几天时间才确定. The oncologist in Napa told me that if it turned out to be APL that would be our first break because it's curable and you don't usually need a bone marrow transplant. When I got the diagnosis, I said I wanted to go to UCSF for care. 于是肿瘤学家联系了Dr. 劳埃德·达蒙，导演 血液学及血液及骨髓移植诊所 加州大学旧金山分校. After a few days a bed opened up and I came to UCSF to start the treatment that would save my life.
那是什么治疗方法?
这是一个耗时近两年的过程. 从他们所说的归纳法开始, an intense form of chemotherapy where you are in the hospital for seven weeks or longer. You can't go outside because you can't be exposed to germs or anything. 因为你的血小板很低，你很容易出血. The doctors and nurses continually warn you not to bump your head or trim your cuticles or do anything that might cause you to cut yourself because you could bleed out. 我不知道我是否真的明白会发生什么.
所以你正在接受化疗?
我只吃一种药, 道诺霉素, 静脉注射和服用另一种药物, called all-trans-retinoic acid or ATRA [which is a relative of vitamin A], 丸剂. 从一开始就是一个又一个的障碍.
你是什么意思??
This particular chemotherapy cocktail has a risk of various complications, 包括血凝块和脑部出血. 我接受治疗大约两周半了, I started feeling a very mild headache and then the pain became so intense it felt like someone was taking a 1,用1000磅的棒球棒敲打我的头. 他们做了CT扫描. Damon told me I had two hemorrhages, one on each side of my brain. 我记得他站在床边, checking me neurologically and asking me to spell "world" backward. 我说:“D... L...," and I don't even think I got to the "R" before asking him, "Can't you pick an easier word?“他们把我转到重症监护室.
你必须做手术吗?
你知道，这就是奇迹. Dr. Damon had told me they might need to drill holes in my skull to relieve the pressure, 但他们没必要这么做. I was given a high dose of prednisone to get the swelling in my brain down.
你是幸运的.
天啊，我每天都感谢上帝. 脑出血是非常非常危险的.
一旦你恢复过来，发生了什么?
然后我不得不继续治疗，不幸的是, the all-trans-retinoic acid can cause a side effect called ATRA syndrome, 这也是你不想要的吗. 它会导致肺部积液. I gained about 20 pounds of fluid that filled my chest and lungs. 我发烧了. 就像得了肺炎一样. 我胸口的压力使我呼吸困难. 我不得不服用利尿剂. And then the antibiotic they gave me for that made me break out into a rash that felt like a sunburn.
所有这些问题一定很令人沮丧.
我知道自己还要接受一年多的治疗, 对我来说，很难看到我将如何做到这一点. Just after the brain hemorrhage I asked my doctor, "Am I going to die?他说:“不，你不会死的。.“我本想放弃，但他给了我希望.
事情改善了吗??
是的，问题确实消失了. They had warned me that any complications would happen in the first seven weeks of treatment. 在那之后，我很好地忍受了后来的化疗周期.
还有一种不同寻常的药物用于治疗APL?
他们使用砷. I was given it 加州大学旧金山分校 and then for 10 weeks on an outpatient basis once I went home.
What did you think when your doctor told he wanted to treat you with arsenic?
我吓得要死. But when you hear from a top expert in the field that this will enhance your chances of a cure, 那你就得去做. 你知道吗?? I had no side effects from the arsenic, which was amazing to me. In fact, during the time I was getting the arsenic infusions I was actually feeling pretty good.
但是砷会引起心脏问题.
来保护我的心, every morning before the arsenic was administered I would have to get an EKG to check my QTc [a measure of heart rhythm.如果速度太快，那天我就拿不到砒霜了.
总的来说，你需要做多长时间的治疗?
我做了三个周期的化疗, where I'd be in the hospital getting chemo for two weeks and then be off for a month to recover. Then I had to keep taking ATRA, one week on and one week off, for a year. 我不太喜欢，但是. Damon said it was an extra insurance policy to make sure we keep all my cells in marching order.
那段时间你被监视了吗?
他们每三周检查一次我的血液, 检查血小板, white blood cells [for signs of infection] and my liver [for signs of toxicity].
什么时候你的血小板计数恢复正常了?
第一次治疗后我的血小板正常. 当我第一次离开加州大学旧金山分校时，他们超过了250人,000 and they did a bone marrow test after I was done with treatment to be sure.
So five years out, are you considered to be in remission or actually cured?
我被治愈了.
Some studies have suggested this type of leukemia may be more common in people with a Latino background?
这是正确的. I'm half Mexican and if the link with my ethnic background had been recognized I might have had a faster diagnosis. I'm trying to alert the Latino community to their risk and get it out into the media. 这些知识可能是挽救生命的信息.
我知道你还在加州大学旧金山分校捐赠了一个奖学金?
It's the Nancy White 赌博 Hematologic Malignancies [Endowment] Fund. It's to support training future fellows who will be training in blood-related cancers. I could not walk away from this whole experience without giving back my thanks and gratitude to the doctors and nurses. 第一个人是10月份开始工作的. 我很高兴见到这个人.
