More on chemotherapy

Today is the midpoint between my second and third chemotherapy treatments. I have a tiny bit of mouth soreness and very minor fatigue, but otherwise no negative effects (except for rapid hair disappearance).

My initial chemotherapy - I've had two sessions with two more to go, and then the chemo will change - is called by the acronym RCHOP. The R stands for a synthetic monoclonal antibody called Rituxan, that "sets up" the cancer cells. It's given by IV. The C stands for Cytoxan, a potent anti-cancer chemical, also administered by IV, along with the H and O parts of the cocktail. H and O have unpronounceable names (unpronounceable by me, anyway), and one of them is a bright cranberry color and turns your pee orangish-red. It takes about ninety minutes to administer the Rituxan, and then about an hour for the other three chemicals. However, for a variety of reasons the whole chemo session takes about five hours.

The session is out-patient, at the Sloan Kettering Westchester branch in Sleepy Hollow - right next to Phelps Memorial Hospital. They have a nice solarium with about a dozen recliners. You can read, sleep, or peck away on your laptop while receiving the drugs. Or call your office.

The P part of RCHOP is the steroid Prednisone, which you take orally for the five days after you've gotten the IV. Also, the day after the chemo, you have to turn up again for an injection of a drug (neulasta) designed to maintain your white blood cell count.

Besides the RCHOP drugs, there's a bunch of stuff you take prophylactically. These include an anti-nausea drug by IV (before the Rituxan), as well as anti-nausea pills, and different oral prescriptions that are anti-fungal, anti-viral and anti-bacterial. So lots of pills, and many of them I will be on continuously while the chemo is underway.

RCHOP seems to be a common treatment for a number of lymphomas, and so far I can detect an effect. Within 72 hours of my first session the small nodules in my neck that were swollen disappeared.

There is extensive information on these drugs online. They always have those adverse reaction warnings - the big adverse reaction, of course, being death. A reminder that chemotherapy is quite serious - these are toxic chemicals! But realistically, the oncologists have massive experience with them and the risks are minimized.

Everyone is different and there are many varied chemotherapy regimens, but I suspect my experience is fairly typical. Especially with the modern anti-nausea drugs, for most people chemotherapy may not be the tough ordeal it was ten or fifteen years ago.