Radiation Decision

This week I start the 2nd third of my chemo regimen. This means that I am one third done and have only 8 weeks to go. This last week was not too bad, but I did experience a cough and shortness of breath, which are both side effects of the Bleomycin. I thought I had caught a cold at first, but the cough was un-productive and lasted a little over a day and was definitely not a result of a cold. Once again, fatigue is the most difficult to cope with. It definitely appears that the side effects of chemo are cumulative because the muscle shaking and general fatigue are both getting worse. But I am still able to go to work 5 days a week, for roughly 40 hours per week.

This Thursday I meet with my oncologist before chemo. My doctor, Dr. Kenney, by my opinion is a great oncologist. He has a passion for lymphoma and his mentor is on the board of the leukemia/lymphoma society. He has access to experts both through his mentor and at Stanford, which developed the chemo regimen that I am on called Stanford V. At my upcoming appointment we will likely make a decision on one final treatment option: radiation. Typically radiation is administered in conjunction with chemotherapy for patients on Stanford V. However, radiation is usually only administered to large masses of cancer, which the average patient usually has. My case is slightly unique in that I don’t have large masses. Instead, my cancer has spread to many lymph nodes throughout my abdomen (my PET scan looked like a Christmas Tree instead of flood lights!). I do have a few clumps of lymph nodes that collectively may be considered a large mass. My doctor is getting many second opinions to help him decide what would be the best course of action for me. Radiation increases the cure rate of lymphoma because it attacks the larger areas where cancer is likely to relapse. Unfortunately it also has a risk of causing secondary cancers later in life. The debate with me is that if we decide to radiate, we would have to radiate a large portion of my chest, which would put me at risk of exposing multiple organs to radiation and thus increasing my risk of secondary cancers. It is a difficult decision for my doctor because I am young and he does not want to cause a secondary cancer later in life, but he also wants to increase my probability of being cured.

I will post the result of Thursday’s appointment and the latest on the radiation decision as soon as possible.