Wednesday, January 26, 2005

Tomorrow, Chemo #5

Thursdays are chemo days, at least every other week. Oddly enough, Sarah and Heather (whose blogs are linked to mine) also both get their chemo on the same Thursdays, so across the country, first Sarah, then me, then Heather will get hooked up. My doctor will also have CT Scan results to go over with me. I'm hoping, if the CT Scans are good, that we may be done at eight treatments instead of twelve. (Four cycles instead of six, as they say in Hodgkins speak.)

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.


Blogger Ken Houghton said...

Actually, it's an algebra equation disguising calculus based on age, gender, expected lifespan, dosage, cancerous cells at the start and end of treatment, etc.

Which does not, of course, make the choice any easier.

January 26, 2005 2:02 PM  
Blogger Unknown said...

Maureen, I hope tomorrow's treatment goes smoothly for you. I'll be thinking of you. As for the CT scans -- well, that's pretty heavy stuff. Here's to good news....and to HOPE, without which, I wouldn't be able to put one foot in front of another.

I'm not sure where my preference would lie, given a choice between more chemo and radiation -- I guess it's just as well then, that I'm not a candidate for radiation. (Too widespread, and non-bulky.)

I'm sure you'll make the most informed decision you're able, and that your hope will not have been for naught.

January 26, 2005 10:34 PM  
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