The worst case scenario

In my last post I mentioned the delayed side effects that may occur post chemotherapy ABVD protocol. One has to be aware of these even if they are rare. I have had my walk in the sun and am ready to address these however difficult it may seem. But better the devil you know. So here goes.

This protocol can cause pulmonary toxicity. The culprit here is Bleomycin. This toxicity develops months to years after completing chemotherapy, and usually manifests as cough and shortness of breath. The statistics are 18%.  What is disturbing is that a study done in 2004 questioned whether bleomycin is necessary at all!  However, at this point it remains a standard part of ABVD. Wonder why?

Adriamycin can cause heart toxicity but the occurrence is rare if the cumulative dose is less than 300 mg/m2 during the 6 cycles. 6 cycles means 12 chemos and Ranjan has been receiving 25mg/m2 which is 300 mg/m2. Just the limit. Worrying!

The last of the big ones is secondary malignancies: lung or acute myleoid leukemia. Studies confirm that the risks after ABVD protocol are less than with other protocols. A study concludes that the administration of six ABVD cycles to patients with stage I and II Hodgkin's lymphoma is a safe therapeutic alternative that might reduce the risk of late and potentially lethal toxicity. Amen to that. One thing is certain: there will be no further chemotherapy or radiotherapy in our case.

It is definitely reassuring to know that the regimen we have followed is the least toxic. But what still disturbs me in all these studies are words like: relapse, survival, remission etc. I just want one word: cure!

But can beggars be choosers. No. So one will have to be careful and plan the coming days keeping all possibilities in mind, even if the incidences are minimal.

I will now look for support alternative systems.

To be continued.

PS: Why are we not told all these things before one decides!