The consultants
had looked again at the pet scan and the number of locations of lymphoma and
decided that the whole thing added up is bigger than they initially thought.
They are changing the treatment from the R-CHOP which I
just had to something stronger after finding worrying extra bits of lymphoma.
The size, location and biochemistry of them are notable and deposits have been
found on my heart, kidneys, vertebrae at the back of neck, the muscle on the
back of the abdomen, pancreas, bowel etc etc! All of these are small deposits
but signal a more aggressive lymphoma.
The main
difference of this is that there is a greater risk of relapse later and of
nervous system compromise. To reduce these new potential problems Dr
Bishton and Dr Martinez-Calle have decided to change my chemo from R-CHOP to a
combination of R-COCDOX-M and R-IVAC.
It will now take
place at 3-4 week cycles alternating from IVAC to CODOX-m twice each and I'll have to be an inpatient, staying
in hospital for about 4 days after chemo. The programme will be about the same
total length but more intense and I'll be staying in a ward.
Although there is less than 5% chance of nervous system
compromise, it would be complicated if it is so they’re going to blast it with
the new chemo.
R-IVAC will be 4-5
days in hospital including the actual chemo and an antidote drug to flush the
system. The blood must be clear of the drug before they’ll let me home. This
will be repeated every 3-4 weeks.
These treatments
will almost definitely make me neutropenic (have a low white blood count) which
makes me extremely vulnerable to infection. If I get a temperature, I need
antibiotics very quickly and go straight into hospital if I've been allowed
home.
The timescale and
prognosis are the same (ish) but the journey to get there may be tougher.
