HOW AM I DOING, A CHEMOTHERAPY STATUS REPORT

I have now had two treatments, and I am pleased to report that I am not feeling too bad. That’s two treatments down and another 22 to go. The routine is as follows: I go twice a week for two weeks in a row. I am off the third week, and then a new cycle begins.

There will be a total of six such cycles, meaning that the total amount of time involved is 18 weeks. Since I took my first treatment on January 7, I’ll finish up the first full week of May, that is, assuming that there are no interruptions for illness.

Pneumonia, A Concern

How likely is an interruption because of illness? Hardly out of the question. In 2002 when I did two separate rounds of chemotherapy—the second one at Johns Hopkins University Hospital as part of a bone marrow transplant—I got a nasty case of pneumonia. The disease was a side effect from the first round of chemicals, and it kept me from proceeding with the bone marrow transplant for several months.

Diseases like pneumonia take hold in the body because one of the results of chemotherapy is an assault on the body’s blood chemistry, for example on the white cell count. It is our white cells that protect us from disease. The fewer white cells we have, the more likely that diseases can infect us.

Watch the White Cell Count

In my case, as a victim of a form of blood cancer called lymphoma and specifically of what is now referred to by the acronym MCL or Mantle Cell Lymphoma, I have a defect in the way my body makes white cells, at least one kind of white cells, the B cells. The chemicals I take then have the job of killing white cells. For me then, close scrutiny of my white cell count is critical.

What chemicals am I taking? I’ve talked about one of them already in a previous posting. It’s called Velcade, trade name for Bortezomib, a product of Millennium Pharmaceuticals. Inc., and Johnson & Johnson Pharmaceutical Research and Development, L.L.C. I also mentioned the fact that during my treatments of 2002 I took a product called Rituxan, a lot of it. Surprise, surprise, I’m taking Rituxan again.

Taking Rituxan Again

According to the website http://wwww.lymphomaininfo.net, Rituxan (generic name Rituximab) is “a monoclonal antibody” that works by taking advantage of the fact that cancerous B cells “have a site on them called the CD20 antigen. This is like a puzzle piece, waiting for a molecular linkup with another substance. IDEC Pharmaceuticals developed the anti CD20 antibody IDEC-C2B8 which links up to the antigen site on the B-cell. This allows Rituxan to target B lymphocytes [for destruction] and not other cells in the body which do not have the CD20 antigen site.”

Sounds like a miracle drug, doesn’t it? Yes, but here it is five to six years later, and I’m being treated for a relapse of MCL. I have to hope that whatever the Rituxan doesn’t get rid of this time around will be knocked out by Velcade, which I pointed out in a posting two months ago is a “proteasome inhibitor,” a type of biochemical whose job it is to promote the natural process in the body of “apoptosis,” that is, the process of eliminating anything made incorrectly. Translation: the elimination of cancer.

Seconds for Velcade Infusion

Another surprise for me as a chemotherapy veteran has been the frequency and the amount of time I am getting the two drugs. For every one time that Rituxan is administered, Velcade is administered four times. The infusion of Velcade takes seconds. The infusion of Rituxan is much slower.

On my first day of infusion, that is, January 7, I was in “the chair” from 11:00am until 3:30pm or a total of four and a half hours. Of that time, Velcade infusion lasted less than a minute. About 20 minutes was taken up with the infusion of drugs to prevent side effects such as respiratory attacks and nausea. The rest of the time or about four hours was all Rituxan. All future infusions of Rituxan, I’ve been told, should last about half the time or about two hours. The first use of Rituxan must be handled especially slowly to guard against an allergic reaction.

Put Directly in a Vein

Lest there be any doubt about it let me make clear that all these drugs or chemicals are put in the body intravenously, that is, they are dripped directly into a vein. None of them can be taken by mouth.

Once I have completed the ordeal, can I expect to be cured? No! My oncologist, on the staff of Wake Forest University Baptist Hospital, made that clear during a preliminary meeting during which the forthcoming procedure was explained to me. “I’m afraid that we do not have a very good record of success when it comes to curing lymphoma,” she stated.

I Love Life

So why am I doing this if I can't expect a cure? Why am I going through the whole not exactly pleasant procedure? For a prolonging of the good years, such as the five good years I experienced after my two rounds of chemotherapy and my bone marrow transplant of 2002. I love life. My mind still works, and I still have a lot of work to do. My wife, family and friends continue to convey the fact that they want me around. Any other reasons for wanting to stay alive pale by comparison to these.

Bring on the Rituxan and the Velcade. Let’s get on with this war.

For a look at the variety of writing that I do, see the website http://www.sasaftwrites.com.

Copyright (c) 2008 by Stephen Alan Saft