Two Years
Two years ago today I received my last round of treatment. I said I would give an account of what happened in the past years, so this is the right occasion to give an overview of the treatment I received.
Let’s start with the official diagnosis: plasmablastair B-cell Non-Hodgkin Lymphoma, CD 20 negative.
The treatment started in Geneva, where I got my first round of CHOP. It was repeated every 3 weeks, 6 times in total.
CHOP is one of the oldest protocols in oncology history and has remained virtually unchanged for almost 2 decades. The first 3 ingredients are delivered intravenously, the 4th one is taken orally.
CHOP:
Cyclophosphamide 1500 mg
(Hydroxydaunorubicin) Adriamycin 100 mg
(Oncovin) Vincristine 2 mg
Prednisone 80mg (5 days)
In Holland the treatment was continued, with some modifications:
- The amount of prednisone was changed to 5 days of 100mg/day, followed by 3 days of 60, 40 and 20 mg resp. for the following 5 rounds.
- During the 2nd round it was decided, the tumor being a stem cell cancer, that a prophylaxis of the spinal fluid was deemed necessary. Let it be noted, that no cancer cells were found in the spinal fluid. During the 2nd round, 15 mg of methotrexate was used (intrathecally).
- However, for the following 4 rounds it was decided to change the prophylaxis from methotrexate to cytarabine, 50 mg. intrathecally.
The problem with a prophylactic treatment is, that by definition (a measure taken for the prevention of a disease or condition), it can only have side effects. About a year ago I asked my oncologist if he knew about the long term side effects of cytarabine. The answer was negative. When I subsequently asked why they made the change from methotrexate to cytarabine, the answer was, that they thought it might be more effective, but that they did not have any scientific underpinning.
After 6 rounds of chemotherapy I decided not to start radiotherapy, as protocol demanded. More on that decision in later entries.
