Her cancer surgery was a success.
Then a genetic condition let a chemo drug ravage her body
Lindy Washburn, North Jersey Record
November 2, 2019
He knew the cure could be more painful than the disease, but his wife’s condition was worse than he could have imagined. Her first chemotherapy treatment after colon cancer surgery had flattened her.
Kerrie Prettitore was 42. She’d come through surgery well, but her oncologist had recommended chemo after cancer cells were detected in one of her lymph nodes.
The New Jersey couple had been upbeat, hoping to maintain a comfortable routine and a positive attitude for their three kids, the youngest of whom was 2. Kerrie’s good health and vitality would carry her through chemo's side effects, they hoped.
But now, shortly after that first chemo treatment, she lay in intensive care at The Valley Hospital, barely conscious. For days she’d been nauseous, suffering from relentless diarrhea, painful mouth sores and scratched corneas. She was running a fever. She had stopped talking, and when her husband, Glenn Prettitore, had asked her to write, she doubled letters and misspelled words. She’d lost 18 pounds.
Kerrie’s chemotherapy, a three-drug combination called FOLFOX, included the drug 5-Fluorouracil, or 5-FU. Patients who receive 5-FU face an increased risk of “serious or fatal adverse reactions,” its label cautions, if they have an unusual genetic condition called DPD deficiency.
DPD deficiency — shorthand for dihydropyrimidine dehydrogenase deficiency — is found in 3 to 5% of the population. It usually has no symptoms other than an inability to break down fluorouracil drugs. People who have DPD deficiency lack some or all of the enzyme needed to process the drug, so it stays active, destroying the body’s rapidly dividing cells.
Most people, like Kerrie, haven’t been tested for the mutation and don’t know they have DPD deficiency until after they receive their first dose of 5-FU or capecitabine, a related cancer-treatment drug. For some, that is too late.
Kerrie’s oncologist arranged for a test.
Glenn looked at his wife and knew she didn’t have much time.
Over the next hours, he learned there was an antidote for 5-FU overdoses that could offer his wife a glimmer of hope. It was available only through a study, however, and had to be given within four days of an overdose. Kerrie had received her 5-FU infusion more than three weeks earlier.
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