Tomorrow, Chemo #5
I am, by temperament, a person who prefers to prepare for the worst, and so I began chemo expecting I would need twelve treatments (six cycles). I made all plans assuming that I would be doing this until May. Then my doctor palpitated the lumps on my neck and said that they were gone, and scheduled a CT Scan. I know that the minimum course is four cycles, eight treatments. If a patient looks clean at that point, the discussion is about whether to follow with radiation (which everyone calls rads), more chemo or nothing.
It's all a balancing of risks.
Known risk--Hodgkins, which untreated is fatal.
Unknown risk--ABVD chemo which can cause heart, lung and nerve damage, and has a very slight chance of leading to what are called secondary cancers. Cancers like leukemia, which probably are a result of the treatment. (Chemo is carcinogenic because it is mutagenic--that is, it can cause DNA damage.)
Unknown risk--Radiation, which can cause immediate damage from burning, and which has a slightly higher risk of secondary cancers.
So the way to reduce the risk of Hodgkins relapse is a full six cycles of chemo and then radiation. I'd be pretty much sure that the Hodgkins was gone. But I would have the maximum risk of damage and secondary cancers.
But if I minimize the risk of Leukemia in twenty years by not getting radiation, I may increase the risk of Hodgkins relapse.
This is something of an algebra equation and it gets discussed a lot on the Hodgkins list serve. According to my doctor, the oncology community specializing in lymphoma discusses it a lot, too. For weeks now, I've thought about it as something to think about when I get there. (One step at a time, or as Bob says, 'Baby steps, Maureen.') But if my CT Scan is good, I may be thrown into some of that discussion on Thursday. So now I'm thinking. And hoping that maybe instead of twelve treatments, I might do eight.
I tend to think hope is bad, because disappointment is soooo bad. But I can't help hoping.