Life is fully of wonderfully ironic parallels. When we were going through the adoption, it really struck me as symbolic that we had exactly five months from the date we were offered Baby H until his due date. I spent exactly five months on bed rest, continually laying on my left side to bring my baby girls into this world.
I guess you can say that I know better than most that five months can feel like forever . And now, I have another five month trial ahead of me.
First, is my chemo. I will be receiving the “Gold standard” for intermediate stage Hodgkin’s Lymphoma. ABVD. (A: doxorubicin (Adriamycin®),B: Bleomycin (Blenoxane®), V: Vinblastine (Velban®),D: Dacarbazine (DTIC-Dome®). Each of these drugs will be given one after the other via an IV into my port. The treatment can last anywhere from 2-6 hours depending on your doctors, dosage and I would guess what your body can tolerate.
I have fourth months of this treatment. Technically, the doctor is prescribing 4 cycles, which are two doses given 14 days apart. So I will have chemo eight times.
Side effects I have to look forward to are:
- Heartburn or acid reflux.
- A temporary decrease in blood cell counts. White blood cells are the cells most affected during ABVD treatment, which increase my risk of infection.
- Mouth sores.
- Flu-like Symptoms such as headache, fever, chills, sinus congestion, and muscle pain.
- Nerve Irritation- Vinblastine may cause numbness or tingling in the hands and feet.
- Nausea and vomiting
- Constipation
- Hair loss
- Heart damage (though not usually at the dose given for Hodgkin’s)
- Lung Damage
- Premature menopause
- Changes in Peripheral Blood Flow (Raynaud’s Syndrome) – Which they are already worried about with my autoimmune marker’s, so this probably makes me more likely to develop this one.
Ooh, ooh, where do I sign up? This sounds like fun!
Nonetheless, every other week on Thursdays, I will hang out as poison drips in my veins to kill this cancer inside of me. The big surprise was the difference in what the doctor proposed in our initial visit versus during his regroup. Since my kids are so young, he spoke of me getting “white blood cell booster shots” in between treatments when we met with him initially as a low WBC is very common with this type of chemo.
During our regroup, we were surprised to find out that he read all of the current research and research shows that the booster shots interact badly with the “B” drug, and increase the risk of lung damage, which is permanent. Current recommendations are to avoid the booster shots entirely during treatment and basically let my WBC bottom out. If I get an infection they will then treat the infection. The other big change between “typical” protocols and mine is that they will try to avoid delaying treatment. This treatment is most effective if given on time and delaying may necessitate additional cycles.
Following chemo, I will have 3-4 weeks of radiation – five months total.
Five months of treatment to let me live longer. It doesn’t sound bad when you say it that way.
Radiation has it’s own challenges. Since the tumors are in the lymph nodes and mine is primarily in the chest, they have to radiate near some very important organs. The biggest challenge is that the tumor basically wraps around my heart and there is a risk of damaging my heart. The hope is that the tumor will shrink enough from chemotherapy and they can radiate carefully to minimize/prevent damage to my heart. If they forgo radiation, since my tumor is so large, there is a good chance the cancer would come back. It also increases my risk of a secondary cancer and/or heart failure.
Surgery cannot be used to remove these tumors given where they are located, and even after chemo and radiation I will have little “lumps” that remain inside me for the rest of my life.
The entire treatment plan is a delicate game of weighing risks and benefits. The doctors have to make judgement calls on what gives me the best chance of survival now and also minimizes possible issues longterm. They don’t want to save me from cancer just to die from a complication a few weeks or years later.
Honestly, in the cancer world, my treatment is short, and it’s a luxury that they even have to worry so much about long-term complications because the long-term survival rate is so high. And those are risks that I will take. Dead is dead and unfortunately very permanent.
If I don’t have treatment there is one ending to this journey, and that would be a pretty short trip. By following my doctors plan, I’ll happily move into the unknown of potential future complications.
Cancer Ever After 