Anna, Mom and I were in Sudbury today for a consultation with Dr. Herst. Here's what we know: The results from the CT scan may indicate a swollen lymph node in my right axilla in addition to the two in my neck. If this is confirmed on the gallium scan, then it likely means I have at least Stage II lymphoma. Could be higher yet. We're still waiting for the radiologist's report on the gallium scan. And the bone marrow biopsy results will be at least another three weeks to come in. Also, one of my blood tests showed that my immunoglobulin levels are slightly elevated. This MAY indicate that I have an indolent follicular lymphoma which has transformed to a diffuse large B-cell lymphoma. What's the difference, I ask? Indolent lymphomas are common. They are slow growing and often simply monitored. They may never require aggressive treatment. However, some will transform into the more aggressive diffuse large B-cell lymphoma. The diffuse large lymphomas are curable. The indolent lymphomas are not.
The intent of treatment of a diffuse large lymphoma is cure. The intent of treatment of an indolent lymphoma is palliation.
Cancer was more fun when I thought I had a curable disease.
This blood result does not mean for sure that I have an indolent lymphoma transformed to diffuse large B-cell. But it may. Regardless, the treatment is the same. I start chemo on Tuesday, with a full day in Sudbury. They'll give me rituximab, a monoclonal antibody, and watch me closely for side effects. Rituximab sounds really cool, it is a protein that specifically targets tumour cells. This means it has very few systemic side effects. If I tolerate the rituximab well, I'll get the full course of CHOP chemotherapy on Wednesday. CHOP is a cocktail of three drugs given IV (cyclophosphamide, doxyrubicin, and vincristine), as well as one drug given orally (prednisone). Assuming my white blood cell levels remain high enough, I will get CHOPped every third Wednesday for eight cycles, or until mid-March.
I'm kinda bummed right now. Should I hope I have the deadly-but-curable diffuse large lymphoma alone? What is the silver lining if I have an incurable indolent lymphoma?