As the powerful medicine took hold, Blake’s immune system weakened—a reality for almost everyone who undergoes chemotherapy.
Cancer-fighting chemotherapy works by obliterating fast-growing cancer cells. But in the process, it indiscriminately hits other fast-growing cells, including the white blood cells that serve as the body’s main defense against infection.
The problem is compounded for the estimated 173,000 U.S. patients every year like Blake, who are diagnosed with leukemia or other blood cancers such as lymphoma or myeloma. These cancers sap the body’s ability to produce immune cells at healthy levels.
When the immune system is down, fungal infections can strike hard. The fungi that exist in a patient’s everyday environment of a patient—usually with no consequence—can turn deadly. It’s such a serious problem that patients with some types of blood cancers are given preventative doses of a potent antifungal medicine, voriconazole, during their chemotherapy treatment. Blake, however, was not.
In December 2013, Blake had just finished a high-dose regimen of steroids, which are commonly prescribed as part of cancer treatment to make chemotherapy more effective. But one downside of steroids, besides mood disturbances, is that they can mask symptoms of other serious conditions. Such was the case with Blake. The day after he finished his steroid regimen, he presented with a high fever and breathing problems.
Jessica drove Blake to the hospital, where doctors examined him for a week, attempting to determine the cause of his fever and neutropenia. First, they checked for pneumonia, but didn’t see anything significant. Then they administered a CT scan for a closer look at his lungs. It revealed a large mass that looked a lot like aspergillosis—an invasive and life-threatening infection caused by a mold that’s prevalent in the environment.
Jessica said she was shocked to hear that survival rate for Blake’s infection was a scant 30 percent for patients with blood cancers. It was more deadly than leukemia. “It was terrifying,” she said.
Blake’s clinical team quickly put him on a potent antifungal drug known as voriconazole. It’s one of the only antifungals available to treat invasive aspergillosis, but it has some significant drawbacks, including potential liver damage.