The Oncologist Visit

So, post blood work, it’s on to the oncologist. We’re greeted by friendly but saddened nurses we’ve worked with before. First Kelly for the initial vital stats and general status questions, then Margret who takes us through the treatment plan and answers a lot of our questions and then Dr. Moltzen who further explains the treatment plan and why it is what it is and clarifies and responds to some additional questions.

So, here is the diagnosis and plan:

  • The growth is a reoccurrence of the 2018 lymphoma
  • It is highly treatable and they are planning for a cure
  • There will be chemotherapy, a different regime than 2018
    • The drugs are not supposed to cause heart damage like in 2018. See MUGA scan on Six Month Followup
    • Hair loss is “sometimes”, last time it was “for sure” 🙂
  • Autologous (I’m the donor) bone marrow transplant

Yeah, that last one is a kicker. Not a lot of details on it yet but we will be getting a call from the transplant team to explain the whole thing in detail. Shortly after starting chemotherapy, likely after Cycle 1 or shortly into Cycle 2 (more on the Cycles in a bit) I’ll be admitted to Health Sciences Centre (HSC) for 1-2 weeks to have the procedure and my recovery monitored. Once HSC gets in the loop I’m at HSC for the rest of the chemo cycles so I’ll need to say goodbye to my St. B. friends and meet a new crew at HSC.

They are quite confident that it’s a reoccurrence of the lymphoma so there is no plan for a biopsy to confirm with a tissue sample. I feel a little mixed about this. Part of me wants to be 100% sure, but the other part won’t miss the biopsy experience.

The next activities on the list are getting a CT scan from the neck to pelvis to see if there is anything else going on as the last CT scan in the ER was just the chest area. Also a PET scan, top to bottom, again looking for any other signs of cancer in my body and to get a read on the known tumour in my chest. There might be a delay in getting the PET scan due to backlogs in the system and if it’s too far out they will start chemo without the PET scan. Once you have the chemo chemicals in you body, PET scans are not useful. So, if that happens, the next PET scan will be post-chemo.

In addition to this there will be another MUGA scan pre & post chemo. Totally painless process, they just inject you with some radioactive stuff and take pictures. How bad can that be.

OK, what about that chemo? So glad you asked (NOT!). But anyway, here goes. It’s known by the acronym GDP-R that represents the drug cocktail they will be using,

  • G Gemcitabine
  • D Dexamethasone (taken my mouth)
  • P cisPlatin
  • R Rituximab

The chemo consists of six cycles of 21 days each so 18 weeks of fun and games. I’m told this protocol is “harder” that the 2018 treatment and this whole process is the “big guns” to kick this lymphoma to the curb.

There are some other implications to all this. We had planned a plane trip to Toronto for Uncle Stan’s 90th birthday party for which we’d recently booked tickets and that’s a “no go” from the doctor. Volunteering at church where I’d hang around with 1,000+ people for 6-7 hours, also a “no go”. Church is fine, go, don’t shake hands, and leave. Exercise like my biking and weight lifting, all good, do whatever you can tolerate, so we’ll see how that goes. I was also going to get my vaccinations updated, nope, put that “on hold” for now.

That’s all for now. I’m feeling good physically, mentally and spiritually and already into some excellent self-care habits so I’m going in strong. I came home and went for a bike ride: Stage 1 Race (D) – Tour of Watopia 2020. Put in a respectable result in my group.

4th !?! Just off the podium

On a more serious note, He is with me and for me. What more can anybody ask for.

Psalm 30:2

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