I HAD A LYMPHOMA/24.

CHOP AND INTRATHECAL TREATMENTS COMPLETED

Finally, we reach the end of the road as far as CHOP and INTRATHECAL Treatments for my cancer are concerned. It seemed somehow fitting that the final Lumbar Puncture was delivered by the top man, Dr Paul Cervi himself. The procedure was as before, Antiseptic, Local Anesthetic and Injection of the drug into the spine with me adopting the foetal position as usual. Dr Cervi took longer than his Junior Doctors, Theodopolou and Islam normally take, a point which pleased Dr Islam when I told him later when he called in during my resting time to wish me well for the future.. I shall see the team again for consultation purposes on 17 February ,when it is probable that I shall be put on 3/6 monthly review subject to developments surrounding potential High Dose Chemo and Stem Cell Transplant at University Hospital in London.Thus, it was time for goodbyes and thanks all round as we finally left the Chemo Centre for, hopefully, the final time. I do have to return to the Hospital tomorrow for 1 Unit of Blood Transfusion to help boost my energy levels for the immediate period ahead, but that is in the Day Unit, located elsewhere in the Hospital

GIVEN THE ABOVE PERHAPS THIS IS A GOOD TIME FOR REFLECTION ON THE PAST 6 MONTHS OF TREATMENTS SINCE THE MESENTRIC MASS WAS DISCOVERED DURING THE OPERATION TO SECURE THE PERFORATED BOWEL BACK IN JULY 2010.

Since then I have learned much about the cancer and the treatment received which may well be of interest and value to others, so brifly below are the key elements of the journey.

Non Hodgkin's disease ,as readers will recall is a form of Lymphoma Cancer that can, subject to early enough diagnosis be treated by Chemotherapy, as in my case. Chemotherapy, whilst in several forms and combinations is essentially the administering of specified drugs directly into the body, usually by drip feed or injection in relevant doses and repetitions at designated intervals to hopefully kill of malignant growth and also dormant cells that could spring up in various parts of the body. Lymphoma, as the name implies seeks often to invade the lymph nodes , especially but not solely, at key points such as arm pits, groin areas etc.In my case a large tumour had attached to the periphery of the liver, whilst an embryonic growth had begun on my chin. Both were exposed by PET/CT Scan and ultimately in like manner, shown to be in remission. This means they are gone as such but there is no guarantee that at some point in the future that the trigger mechanism which instituted the attacks will not return to recommence tumour growth at some point in the body. Thus treatment by Chemotherapy centres both on initial killing/control of the existing tumour{s} and subsequently seeking to raise the preventative barriers to seek to avoid any return of the problems encountered.

Initial treatments vary according to type of cancer. In my case a 4 dose of what is termed Chop Treatment was invoked. Chop treatment, administered usually 14 days between each application consists of 4 items on each occasion. Chop is the name given as it contains the initials of the drugs used if given a bit of imagination! They are as follows:

{C} YCLOPHOSPHAMIDE.

{H} DOXORUBICIN. {The H comes from the chemical name ydoxydaunorubicin}.

{O} VINCRISTINE, { It used to be called Oncovin}.

{P} PRENDISOLONE {This is a steroid}.

The first 3 above are administered by injection or drip feed whilst the steroid is taken in tablet form for five days in each cycle commencing at the time the other doses are administered at the Chemo Centre. Initially I was prescribed 4 cycles and after the PET/CT Scan taken then it was determined to increase to 6, then 8 to invoke and assist the preventative process, the first 4 having dealt with the immediate problem.

In addition 4 INTRATHECAL LUMBAR PUNCTURES were then prescribed to assist prevention in the key areas of Spinal Cord and Brain. These ,as the name indicates are injections directly into the Spinal Cord and are usually administered on a 14/21 day cycle. This procedure would then normally conclude treatment with the patient returning for reviews on a 3/6 monthly basis. Now however, research has revealed that a High Dose Chemotherapy and Stem Cell Treatment can significantly increase prevention of a return of the disease. The cut off age for this is normally 65 but my Hospital believes I could benefit from it. The downside is that it requires a stay in a London Hospital for 3/4 weeks, some in isolation to prevent infection and there is also a small mortality risk.

SIDE EFFECTS- CAUSES AND EFFECTS!

No resume of cancer treatment can be complete without reference to side effects brought on by the administered drugs. Awide variety can ensue and whilst not free of all, I acknowledge that Ihave been fortunate in having so few and especilly not experiencing the sickness and general feeling of unwellness that besets others during the treatment period. Ihave had, tingling extermities, cold slab thighs, mouth ulcers, nose bleeds, headaches and energy loss to name the key ones. Some linger on yet and they say could be with me for 3/4 months more.

Since my last dose of Intrathecal Treatment I have been plagued with some of the above side effects and especially, tingling in the fingers and toes, mouth ulcers and energy loss. In fact I had to call in my brother in law to repair a fuse for us as my fingers behaved like sausages and refused to deal with the installation of new fuse wire at all! Eventually, I contacted our Senior Nurse, Avril earlier this week,and we had a full discussion. We noted that my last Chop Treatment had been 6 days prior to Intrathecal 3 and Avril determined that the side effects were probably most to do with the cumulative effects of the 8 Chop Treatments rather than just Intrathecal.

I, whilst unsure on this, did agree that the symptoms began to lessen 14 days post Chop and 8 post Intrathecal and that it could well be the case. Then 17 days post Chop and 12 days post Intrathecal ,the effects had diminished further though fingers and toes still tingled, whilst being more useful and energy was still lower than I would have wished. For example 25 minutes of hedge trimming completely exhausted y, when normally it would have easily been taken within my stride and mounting the stairs to PATHOLOGY to get Blood Tests rushed through this morning, had me blowing!. Avril had focused on the energy loss and as a result Dr Cervi has prescribed the 1 Unit Blood Transfusion referred to above fllowing readings on Haemoglobin and Platelet levels. At least I was not Hydroponic as happened last time.

This last scheduled visit to the Chemo Centre enabled my my wife to distribute "Thank You" Cards and boxes of Chocolates all round to reflect our feelings towards the care and consideration shown to us by all there over the past difficult 6 months.Individually and collectively they could have done no more and we are truly grateful to everyone involved.

ON TO HIGH DOSE AND STEM CELL TRANSPLANT?

A call EARLIER THIS WEEK from University College Hospital in London, fixed Thursday next, February 3rd as the date of my appointment to discuss the potential High Chemo and Stem Cell Treatment. However, it transpires that it will be Prof Linch, not Goldstone, I shall see. Prof Goldstone is to retire and Prof Linch is to be the new lead. A quick google on Prof Linch UCH removed any qualms on succession for said Prof is no boy wonder but a vastly experienced and innovative leader in the field. We look forward to meeting with him, armed with questions, made all the more comprehensive from reading the LEUKAEMIA RESEARCH CHARITY on the subject supplied by the ever helpful Avril and which leaves no stone unturned in dealing with the treatment, side effects and recovery times. I can tell you I have much to ponder on here and will report fully on the information shortly, devoting a whole Hub to the information received.The end here now seems very much like a beginning that I may not yet be ready for but more on that anon!.

To expand on that briefly, at this stage, I would refer to "the cumulative effects of Chemo"as advised by Avril as perhaps being the cause of present discomfort and the advice of my old friend Dr Sinha, that whilst going for the treatment is a good thing, that maybe a gap of 8/10 months to allow the body recovery from the treatment undergone may be a wise direction to follow. Clearly these are areas that exercise my mind and must be paramount in discussion with the Prof if he advocates me as a suitable case for this High Dose Treatment with all that it involves.

MY DILEMMA AND A REQUEST.

At the outset of this journey I determined to follow to the letter, the advice of the Medics and have done so with excellent results to date. I am still minded to continue this path but the extreme nature of the treatment, the normal age barrier and the mortality issue do cause me concern. Currently, listening to my body it seems to tell me, "O K! So far so good but for 6 months now you have plied me with Chemicals that have been absorbed and have done a job for us. Now hover, I would appreciate something of a quiet time for me to enjoy some rest and recuperation and get things flowing again free from outside intervention to help me do that" Is that reasonable or am I attempting the dagerous practice of being my own Doctor? How else could potential dilemma to be solved and this particular circle finally squared. Comments please at your leisure to advise on your thoughts on the matter.

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