Preparing for Treatment with Provenge
Preparing for treatment with Provenge requires more steps than do other prostate cancer treatments. Let’s assume you, along with your healthcare team and your loved ones, have decided you are going to undergo treatment with Provenge. As you probably already know, Provenge (sipuleucel-T) is unlike all other drug treatments for prostate cancer: you don’t go to the pharmacy and pick up a prescription or make an appointment for an infusion of an off-the-shelf medication.
Instead, each of the three doses of Provenge involved in the immunotherapy course will be prepared especially for you, using your own blood cells. You will need to adhere to a strict schedule of preparation and dosing over a five-week period. Although this schedule is not difficult, it is outside the usual realm of experience for the majority of patients. Therefore, the drug maker, Dendreon, has developed guidelines, which it calls SPARK, for preparing for treatment with Provenge. Here’s a look at that process along with an explanation of what to expect along the way.
Preparing for Treatment with Provenge: Comfort Kit
After you make arrangements to begin your treatment program, you will receive a Comfort Kit from Dendreon. It consists of a wheeled backpack that contains an iPod type player, individual drink mixes, a plastic travel bag (contents: ear plugs, sleep mask, lip balm, antibacterial gel, and lotion), a stainless steel water bottle, stocking hat, a Sudoku puzzle book, crossword puzzle book, appointment calendar, and a pen and pencil set. These items may come in handy while you are undergoing the three cell collection sessions (leukapheresis; described below), each of which lasts 3 to 4 hours, and your three treatment sessions.
You are invited to bring other items along as well, such as a tablet, e-reader, handheld video game, books, or board games. Feel free to bring along a friend or loved one who can pass the time with you as well.
The most important item in your Comfort Kit may be your appointment calendar because it is critical that you keep every appointment for leukapheresis and subsequent Provenge treatment. Each Provenge treatment is designed just for you, and it has a very short shelf life. Therefore, if you miss an appointment or are not prepared, the dose will not be usable and you will need to schedule additional sessions.
Preparing for Treatment with Provenge: Leukapheresis
Perhaps the part of preparing for treatment with Provenge that differs the most from other prostate cancer treatments is getting ready for and undergoing leukapheresis. You may want to use the appointment calendar provided in your Comfort Kit to make notes for your preparation process. Several days before your scheduled leukapheresis, make sure you stay well hydrated. The morning of the procedure, do not drink caffeinated beverages, such as coffee, tea, or hot chocolate. Noncaffeinated herbal tea is an option. However, you may want to choose calcium-fortified orange juice. Leukapheresis can cause calcium levels to decline, so it is recommended you eat a calcium-rich breakfast before the procedure. Other suggested foods include calcium-fortified cereal, yogurt with almonds, or oatmeal with banana.
Be sure to dress for success: a loose-fitting, short-sleeved shirt that buttons down the front will allow for easy placement of the catheter. You will need to sit in a reclined chair for several hours without being allowed to walk around, so wear comfortable pants with a fly that will allow you to use a portable urinal (provided by the clinic staff) should you need to do so during the procedure. It is recommended you make a bathroom visit before leukapheresis begins.
Bring the same photo identification you used when you signed up for Provenge treatment. Finally, arrange to have someone drive you home after leukapheresis. Although you will not receive any sedation during the procedure, many men feel tired after the cell collection process.
It is possible your doctor may have other instructions for you regarding preparing for treatment with Provenge. Be sure to follow them.
Cell Collection: Leukapheresis
The first step of Provenge treatment involves a cell collection technique called leukapheresis. You will go to a blood collection center, where technicians will place a catheter into one of your veins in your arm or chest. While you relax, your blood will flow through a machine and be filtered so immune cells can be gathered to make your Provenge dose. The blood that is not used to make the dose is returned to your body.
Occasionally, some men experience side effects during leukapheresis, such as numbness and tingling of the feet, hands, or mouth, as well as chills, dizziness, fainting, and nausea. These may be prevented by eating a breakfast of calcium-rich foods. If you feel any of these symptoms, tell the medical staff immediately.
The collected blood cells are sent to a laboratory where they are separated and the white blood cells are preserved and treated, with the result being your own unique dose of Provenge. Within three to four days of leukapheresis, you will return to your doctor for your dose of Provenge.
Your Provenge infusion will take about one hour, with some additional time both before and after treatment for preparation and recovery. Again, you may want to bring along items from your Comfort Kit or something else to do during the treatment.
If you keep all of your scheduled appointments, the entire process of three leukepheresis procedures and three Provenge infusions will take five weeks. If at any time while preparing for treatment with Provenge you have questions about what you need to do, side effects, or other concerns, contact your healthcare provider immediately.