My Treatment History

Weapons of my cancer war!

The type of lymphoma that I have is slow growing and responds well to treatment, but it is very hard to cure. It is common for this lymphoma to come back after treatment, although it can take years to do so. It is not always clear if treating the lymphoma right away is helpful. Because of this, some doctors recommend no treatment until the lymphoma has begun to cause problems other than mildly swollen lymph nodes. Some patients may never need treatment at all. In those that do, treatment is needed after an average of about 3 years.

If treatment is needed and the lymphoma is localized to 1 lymph node group or to 2 nearby groups on the same side of the diaphragm (stage I or early stage II), it can often be treated with only radiation therapy to the lymph node areas.

Regardless of the stage of the lymphoma, there are usually several treatment options. Many doctors will first try rituximab (Rituxan) combined with chemo, using either a single chemo drug (such as bendamustine or fludarabine) or a combination of drugs, such as the CHOP or CVP regimens. Rituximab alone or chemo alone (either one or several drugs) may also be used. Large areas of follicular lymphoma may also be treated with radiation to reduce symptoms, even if it’s not stage I or II.

The radioactive monoclonal antibodies, ibritumomab (Zevalin) and tositumomab (Bexxar) are also possible treatment options, although they are more often used as second-line treatments than in newly-diagnosed patients. They are usually given alone, but in some cases chemo may be given too.

For patients who may not be able to tolerate more intensive chemo regimens, rituximab alone, milder chemo drugs (such as chlorambucil or cyclophosphamide), or both may be good options.

If the lymphoma shrinks or goes away with the initial treatment, doctors may advise either close follow-up or further treatment. This might include either rituximab for up to 2 years or treatment with a radioactive antibody. Further treatment may lower the chance that the lymphoma will come back later and may help some patients live longer, but it can also have side effects.

If follicular lymphoma doesn’t go away after initial treatment or if it comes back later, other treatment approaches such as using different chemo drugs, monoclonal antibodies, or some combination of these can be tried. If the lymphoma responds to this treatment, a stem cell transplant may be an option.

In some cases, follicular lymphoma can change (transform) into or return as a diffuse large B-cell lymphoma. When this happens, the treatment is the same as for this more aggressive disease.

My First Treatment

The first treatment after being diagnosed was a regiment called “CHOP”

CHOP is an acronym that represents a commonly used combination chemotherapy regimen in cancer treatment.

CHOP consists of the following drugs:

  • Cyclophosphamide
  • Hydroxyldaunorubicin (doxorubicin)
  • Oncovin (vincristine)
  • Prednisone

A Typical CHOP Regimen (regimens should be tailored to the individual)

  • Cycle length: 21 days
  • Number of cycles: 6-8
  • Day 1: Cyclophosphamide (IV); doxorubicin and vincristine (IV push)
  • Days 1-5: Prednisone (oral)

What CHOP is effective for and why

CHOP combination chemotherapy is most often used against sub types of non-Hodgkin’s lymphoma. These subtypes include chronic lymphocytic leukemia(small lymphocytic lymphoma), AIDS-related B-cell lymphoma, and anaplastic large T-cell lymphoma (ALK+). It has been used against peripheral T-cell lymphomas other than ALTL (ALK+), but results have never been very encouraging. Prior to the introduction of Rituxan, CHOP was the standard treatment protocol for many non-Hodgkin’s lymphomas.

My Second Round Treatment

After several years after my initial treatment the enemy returned to mount a second attack. Shortly after my first treatment a new drug was released onto the market that was a result of many years of research and clinical trials. This new drug was designed to be for more specific types of cancer and was a whole new way to attack the enemy without all the harmful side affects and damage to the other organs of the body. This new treatment used a monoclonal antibodies.

Antibodies are proteins made by the body’s immune system to help fight infections. Man-made versions, called monoclonal antibodies, can be designed to attack a specific target, such as a substance on the surface of lymphocytes (the cells in which lymphomas start).

Rituximab (Rituxan®): This is an antibody that attaches to a substance called CD20 found on some types of lymphoma cells. This attachment seems to cause the lymphoma cell to die. The treatments are given as intravenous (IV) infusions in the doctor’s office or clinic.

When used by itself to treat lymphoma, it’s given weekly for 4 to 8 weeks. When combined with chemotherapy, it is most often given on the first day of each chemo cycle. For some lymphomas, it may be given after chemo as maintenance therapy. In that case it’s given weekly for 4 weeks in a row, every 6 months for up to 2 years.

Common side effects are usually mild but may include chills, fever, nausea, rashes, fatigue, and headaches. Rarely, more severe side effects occur during infusions, such as trouble breathing and low blood pressure. Even if these symptoms occur during the first rituximab infusion, it is very unusual for them to recur with later doses. This drug may also increase a person’s risk of certain infections for up to 6 months after the drug is stopped.

My Last “Traditional” Treatment

After each use of Rituximab, it is known that the cancer cells become less and less affected by the antibody. Such was my case.The last treatment only held off the enemy for six months so it was time to try to find something better. This was one of the reasons that I decided to sign up for a clinical trial drug.

On to Experimental Drugs

I managed to get signed up for a Clinical Trial being offered by Bayer Pharmaceuticals called Bay80-6946/16349. It is a Stage 2 Trial drug which is a PI3K inhibitor. This means that the study is trying to find out if this drug will block and enzyme called Phospho-Inositol-3-Kinase (PI3K) which is normally important for the growth of tumor cells. With out going into too much detail, it is hoped that this drug will interrupt the normal growth of my tumors. Not meant to be a cure, only a way to beat back the cancer by causing tumors to not be able to grow.

Time for Unconventional Treatments.

My Clinical Trial started to work in the trial period but several months into the trial, it stopped working and my tumors grew larger indicating that the drug had become ineffective against my cancer, Protocol of the treatments was that if the patient had any sign if progression of the disease, treatment would stop and the patient would be ejected from the trial.

So now I have made a choice to try to treat myself in a very unconventional way using Hemp Oil. >> See more here.

 

 


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