Susan and I spent yesterday afternoon in Chemo 101 learning about R CHOP. That’s the regime I’ll start on Tuesday and repeat every three weeks for six cycles. I’ll wind up with more pharmaceuticals in me than a rock star.
Sharon, an oncology nurse, spent several hours with us. She is warm, personable and a consummate professional, as are all the Memorial Clinic staff we’ve met so far.
The goal of chemo is to kill part of your body without killing all of you. It involves lethal drugs that do serious damage, hence the side effects. The drugs work by damaging RNA or DNA that control cell division. If cells are unable to divide, they die. Healthy cells grow back; hopefully the cancer cells won’t.
R-CHOP is the standard treatment for what I have, aggressive Diffuse Large B-Cell Lymphoma. It is a relatively new drug cocktail that’s proving quite effective.
R – Rituximab is a monoclonal antibody given as an infusion over several hours on the first day of treatment. It is an immunotherapy that targets B-cells. Side effects can include infusion reaction, fever, chills, nausea, weakness and headaches. It also can lower platelet and white blood counts, increasing the chance of infection.
C – Cyclophosphamide (also called Cytoxan/Neosar) is a derivative of mustard gas. It slows or stops cell growth. It also lowers the immune system’s response to various diseases. Side effects can include nausea, vomiting, bone marrow suppression, mouth sores, diarrhea, bladder irritation, alopecia (hair loss) and lethargy.
H – Doxorubicin (trade name Hydroxyldaunorubicin, hence the “H”) is an antitumor antibiotic known as “Red Devil” because it turns your urine bright red. Side effects can include nausea, vomiting, neutropenia (decrease in white blood cells) and hair loss. The main danger is heart arrhythmias and congestive heart failure, which is why there’s a lifetime cap on dosage.
O – Vincristine (trade name Oncovin, hence the “O”) is a “besicant” that causes extensive tissue damage. It interferes with cell growth, both cancerous and normal. Side effects can include peripheral neuropathy (nerve damage, usually temporary), hyponatremia (an electrolyte disturbance), constipation, hair loss, low blood counts and weight loss.
P – Prednisolone is a corticosteroid drug taken orally for the first five days of treatment. It decreases inflammation around tumors by interfering with white blood cells. Side effects can include fluid retention of the face, acne, constipation and mood swings. It can also cause blurred vision, increased thirst, confusion, nervousness and insomnia.
The good news is that most people don’t get all these side effects. We’ll see how my body reacts and how well my mind can hang on for the ride.