Day 36 – Friday (9/28/18)

Health Update:  Today was the big day, and I was given a massive amount of information.  I will try to summarize everything here for my benefit (and yours).

  • My chemo regiment will be 6 cycles of 3 weeks each. There will be another PET scan after the 2nd cycle to make sure things are working as expected.  There will be another PET scan after the 6th cycle to make sure everything is gone.  If there are still active cancer cells, then the regiment could be extended an additional 2 cycles.
  • After the chemo cycles are complete, I will then have 4 weeks of radiation to specifically target the large mass in my chest. The goal at the end of the chemo and radiation is that I’m cancer-free, and that blobby is dead and “shrunk”.  It is my understanding a smaller dead blobby will always exist inside of me.  It won’t complete disappear.
  • Each cycle of chemo will consist of 5 different drugs, designated by the acronym RCHOP.
    • R – Rituximab
    • C – Cyclophosphamide
    • H – Doxorubicin (hydroxydaunomycin)
    • O – Vincristine (Oncovin)
    • P – Prednisolone
  • As we go through each cycle, I will have to have labwork conducted multiple times per cycle. There are several things the doctors have to monitor for (side-effects) that can be mitigated as they occur.  Some side effects to expect include:
    • Nausea
    • Hair loss (the doc looked at my head and said “probably not a big deal for you”, haha)
    • Fatigue
    • Low blood count
    • Risk of bacterial infections needs to be closely watched
    • Bowel issues
    • Numbness in hands and feet
    • Uric Acid issues (leading to gout)
    • Tumor Lysis syndrome (Blobby could explode and dead tumor cells enter the blood stream and have to be processed).
  • The first chemo cycle is scheduled to start Friday, October 5th at 8:00am. In order to meet that schedule, there are three prerequisites I must complete before Friday:
    • On Monday I have an EKG and bone marrow biopsy scheduled
    • On Tuesday I will have a consultation for a port to be installed (to administer the chemo)
    • On Wednesday or Thursday, I’ll have an outpatient procedure to install the port.
  • Why do I need an EKG? We must establish a baseline for my current heart condition / functionality.  One of the drugs in the chemo regiment has a side effect that can damage the heart.  This must be monitored throughout the process also.
  • Why do I need a bone marrow biopsy? Currently, I’m classified as Stage 2.  If the bone marrow biopsy is positive for cancer, then I immediately become Stage 4.  The doctor feels this is low risk for me, but said it is something we must know.  He said the treatment plan won’t change if it is positive, but the prognosis changes.
  • The prognosis at this point (being stage 2) for a “Non-Hodgkin’s primary mediastinal large B-Cell lymphoma” (abbreviated PMBCL) is 80 – 85% likelihood of being cancer free and living at least 5 years past the date of discovery (data stops at 5 years). If I were to be at stage 4, it drops to 70%.  Out of all Non-Hodgkin cases, PMBCL accounts for only 2%, and is primarily found in adolescence or young adults.  Looks like I’m a pretty typical, atypical case, haha.

Well, I think that about covers it.  I may recall more (or be able to interpret the 7 pages of notes better) in time, but for the moment, I think I have hit all the high spots.  How am I feeling at the moment, emotionally?  Honestly, ready to go.  We found a problem.  We identified the problem.  We identified a plan.  Now let’s execute it (and blobby)!

Dear heavenly Father, You have not let me down yet.  There have been numerous “small” things throughout this process that You have worked out.  Knowing You helped with the small things helps reassure me that You will help with the big things.  It’s go time on the big things.  I know that You worked with the doctor to guide him in the regiment I need to follow.  I’m confident that I will go through the treatments, with You by my side, and we will come out victorious on the other side.  Thank You Lord for being in the middle of the storm with me.  Amen.