A good day...

Guess who has no signs of Lymphoma in his bone marrow?? That's right! We heard today these results from the biopsy and were elated. In additon we had a great afternoon with a very nice Oncologist at Vandy who echoed with almost perfect consistency the same treatment advice we had been told in Atlanta. Rather than elicit further doubts, I believe we're on the road to greater certainty and conviction.

One thing that is new info, but not too material, is that there is an indication of the cancer in the lymph nodes near my small intestine/upper abdomen. While this is a 'new' location for seeing the cancer, it still keeps me at a stage II and does not materially change the outlook.

Since this cancer has decided to attack my GI-tract, I will likely need a colonoscopy (a wrong way journey up a one-way street) and an endoscopy (tube going from the mouth down into the upper GI) mid-way through chemo in order to visually see those places, rather than rely on a PET scan.

All in all, the 'R-CHOP' chemo regimen will be the course of action. I will start as soon as feasible and can expect 6-8 sessions with a scan and the 'scopes' (mentioned above) after the 4th treatment to see how things are progressing. What scares me now is just how potent these drugs (poisons, really) are, and what are the lasting effects on the human body. I guess these lasting effects are at least better than those of untreated cancer!

Today, the doctor was very clear: if left untreated, I would most likely be dead within a year. Sobering, indeed. So let's get moving, right?

A reader's digest for R-CHOP:

R - Rituximab is a monoclonal antibody given as an infusion over several hours on the first day of treatment and more quickly with each subsequent treatment, once it's evident there are no allergic reactions. It is an immunotherapy that targets these cancerous B-cells. Side effects can include a harsh infusion reaction, fever, chills, nausea, weakness and headaches. It also can lower platelet and white blood counts, increasing the chance of infection. So, if you're sick or think you're sick, please do me a favor and stay away (for now).

C - Cyclophosphamide (also called Cytoxan/Neosar) is a derivative of mustard gas. It slows or stops cell growth. It also lowers the immune system’s response to various diseases. Side effects can include nausea, vomiting, bone marrow suppression, mouth sores, diarrhea, bladder irritation, alopecia (hair loss) and lethargy.

H - Doxorubicin (trade name Hydroxyldaunorubicin, hence the “H”) is an antitumor antibiotic known as “Red Devil” because it turns your urine bright red. Side effects can include nausea, vomiting, neutropenia (decrease in white blood cells) and hair loss. The main danger is heart arrhythmias and congestive heart failure, which is why there’s a lifetime cap on dosage.

O - Vincristine (trade name Oncovin, hence the “O”) is a “besicant” that causes extensive tissue damage. It interferes with cell growth, both cancerous and normal. Side effects can include peripheral neuropathy (nerve damage, usually temporary), hyponatremia (an electrolyte disturbance), constipation, hair loss, low blood counts and weight loss.

P - Prednisolone is a corticosteroid drug taken orally for five days with each treatment. It decreases inflammation around tumors by interfering with white blood cells. Side effects can include fluid retention of the face, acne, constipation and mood swings. It can also cause blurred vision, increased thirst, confusion, nervousness and insomnia.

So... so long as none of those side effects take hold, and I don't have permanent heart damage, and the chemo kills all the cancer, and I do not relapse, I should be all set. In other words, keep praying.

On a side note, forgiveness is a beautiful thing. I would encourage any of you who may be holding onto something, regardless of how seemingly insignificant, and take it to the place where it belongs: at the Lord's feet. Having a weight lifted from you and hearing forgiveness spoken aloud is enacting freedom. I have enjoyed some very tender moments with Candace today. I've been gifted with a wife who is understanding, loving, and very compassionate when it comes to my shortcomings. Maybe you, too, can re-connect with a friend or loved one (or maybe even un-loved one!) in any areas that need to be let go -- once and for all. I promise you will be lighter on your feet for doing so.

Onward and upward. Let's do this.