Paul's Heart

Treatment Options For Hodgkin’s Lymphoma

Medicine has come a long way in the 25 years since I was treated.  But medicine has a long way to go.  While many cancers have high cure rates, often those cures have come at a cost because of the late developing side effects, hence “Paul’s Heart.”  But I am able to tell you, that in spite of my treatment options now pretty much obsolete, or no used when no other choice, treatments today, while safer, are not 100% safe.  The newer treatments still produce remissions, but also still allow recurrences.  But also in some rare cases, lethal incidents.

Current options have increased dramatically.  Where it used to be believed that Hodgkin’s could be treated with radiation therapy alone, medicine advanced to chemotherapy, and today, other alternatives.

The first option I chose, whether it was the correct one or not (my doctors recommended chemo followed by choice), I chose to do radiation therapy alone.  If radiation did not work, then I would have to go forward with chemotherapy, but if it did, I felt that I would not have to endure the stereotypical nasty side effects of chemo.  After all, in my mind, I had reduced radiation therapy to nothing more than just 30 days of x-rays.  And I could handle that.

Now, there is a big difference between how radiation therapy is administered today and back in 1989.  I was given 30 treatments, totaling 4050 cGy, the unit used to measure.  To the common person, this number means nothing.  But to anyone who works with radiation knows, as does medicine today, this level is four times the maximum lifetime exposure to ionized radiation.  But as far as medicine was concerned back then, it cured Hodgkin’s Lymphoma.  But ask anyone who was treated with radiation prior to the 1990’s, it did more than just cure our Hodgkin’s, decades later, long after we were not to have survived more than five years, and we will tell you the medical nightmares that our bodies have become (see “CABG – Not Just A Leafy Green Vegetable” for my story).

Fortunately, in the 21st century, medicine has learned that it can cure Hodgkin’s with the same success, using less radiation, and more defined instead of the “scattered field” technique like was used on me.  I simply laid on a table, and was hit with a radioactive beam from my jawline to my lower abdomen.  In other words, a scattered field.  My body got radiation to areas that were otherwise healthy, with no sign of Hodgkin’s.  Doctors now believe that they can treat more successfully with less.

I ended up having to go through chemotherapy anyway.  While it was not the horrific experience that I remember seeing broadcast on television and movies, it was still rough.  Depending on the chemotherapy cocktails used, there are several options, chemo is meant to do only one thing, kill cancer cells.  But since chemo is not intelligent, it cannot just kill cancer cells, so it also impacts healthy cells.  This is one of the reasons many cancer patients experience hair loss.  Fortunately, the hair does grow back, and while we love our hair, there is no treatment for the hair loss during chemo.  However, healthy red and white blood cells are needed for our survival.

Back in my day, we were not treated if our blood levels were too low.  But today, patients can get booster injections to increase red and white blood cells to allow the best opportunity for treatments to continue uninterrupted.

Of course the image that most people have are patients hooked up to IV lines, in hospital beds.  I was treated as an outpatient, in a dungeon-like environment.  Almost twenty minutes each treatment  was spent just finding a healthy vein to use as the chemotherapy had reaked havoc on my veins each treatment.  Today, patients sit in chemo suites with other cancer patients, watching TV, listening to guest musicians play songs, visits from therapy dogs, and eat lunch.  And to make the injection process easier, ports are surgically implanted to all consistent and simple access for the IV line to carry the chemotherapy.  Oral chemotherapy may also be included.

While both radiation and chemo have improved in both safety and success, it is still not giving 100% survival.  I do not know that much about the following options that are now available, but they are to be kept in mind, that progress is being made:

immunotherapy – using vaccines and other methods to make your body use its own immune system to fight the disease

bone marrow transplants/stem cell transplants – using the patient’s own marrow, usually combined with higher doses of chemo

allogenic transplant – using stem cells from a donor, usually sibling, or matched donor, combined with higher doses of chemo

clinical trials – these are the newest of possibilities, little known about long term side effects, and the treatments have not been approved by the FDA as official treatments, but for patients who have no other hope, perhaps the best option available.

alternative therapy – this is a tough one, because I do believe that there are options from nature itself.  I strongly believe however, in going by what has been scientifically proven first.  Then, and only then, I will concede to a complimentary therapy which uses conventional means, along with alternative – but only, and ONLY after consulting with the treating oncologist.  Alternative medicines, even vitamins can have profound impact on the effectiveness of chemotherapy and the body.  And while not to be a killjoy with alternatives, if that is the only chance left, then you should go for it, if that is what you believe.

Yes, progress has been made.  But there is still so much more that can be done, and needs to be done.