Stage 2 B cell NHLTreatments.

gs963 · Regular Joined: 27 Jul 2009 Posts: 20

I just got the word that my 80 yr old mother will be having 6 treatments.And that it will be one every 3 weeks. No Radiation will be used. The Dr. seemed to think that they will eliminate what she has with the treatments and that she should handle it fine. The DR. said they will be using the newer drugs. R along with others. I dont have the exact Drugs yet. Does the treatment just one every 3 weeks sound correct? I could have heard it wrong. I thought one had treatments daily.

ChemoMan · Posted: Tue Aug 25, 2009 9:29 pm Post subject: Re: Stage 2 B cell NHLTreatments.

Hi gs963

Sorry to see you posting about this. Not the place anyone wants to be. RCHOP is usually done all on the same day and you also get to take pills for five days, including chemo day. The pills are prednisolone/prednisone. The first treatment takes a long time about 6 hours, as the doctors need to determine what your Mum's response to the Rituxam is. After that it is usually done in about 4 hours. Sometimes the rituxam is done on a different day but this is very rare, and may happen if your Mother has porblems with it.

Good luck, don't be too worried as your mother has a very good chance to be in remission at the end of this. We are always here to help if you need us.
_________________
Age 53
Diffuse Large B cell Lymphoma
Stage 2a
Finished six cycles of R chop 21 26th May 2008
Officially in remission 9th July 2008
Remission confirmed 1st October 2008
Remission confirmed 17 June 2009
http://cancerforums.net/viewtopic.php?t=9620
RULE NUMBER 1.....Don't Panic
RULE NUMBER 2..... NEVER GIVE UP
RULE NUMBER 3..... Don't forget the first 2 rules

SingleDad

Hey GS

Very good chance of remission but depends on the stamina...it's no fun - I'm just recovering from the side effects and I'm 2 decades younger.

Has she got someone living with her???

Nutrition is very important to keep the immune system functioning....her blood tests and weight will be watched prior to chemo to track her progress.

Depression takes it's toll on many as well.- the medical community has made astounding progress but your mum is 80 after all and chemo is quite the assault.

That said I think there was someone around here taking it successfully at 93 Shocked

..good luck - one note - she might be less concerned than you - keep it that way and follow her lead on positive outlook....keep your own fears at bay but also be realistic.....sometimes I think it's trickier to support a cancer patient than enduring the treatment.
_________________
Age 62
Diffuse Large B cell Lymphoma Stage 2/3
CHOP+R started Feb 26th 2009
Completed 6 cycles June 2009
Diary here http://cancerforums.net/viewtopic.php?t=12003
Officially in remission July 9th 2009 Wink

Three rounds of Intrathecal completed July 29th
Radiation as a prophylactic measure.
1st Radiation Sept 9 completed Oct 1.
Cancer free scan Jan 2010 - remission confirmed
In South Africa for three months

gs963 · Regular Joined: 27 Jul 2009 Posts: 20

Thanks Chemoman. It really helps hearing the facts about all of this.
Single dad She lives alone for now. Her sister who is 83 lives across the street. Both are in very good health for their age. She will have the help she needs though when the time comes. This person is 80 and never even had a personel Dr. She has never taken any types of medicine after 80 years. I know hard to believe. She is not a DR. person for sure and I know I need to keep her attitude positive on all this treatment.I know she will need every bit of her strength for this. Thanks for the help.

joepet · Senior User Joined: 18 Dec 2008 Posts: 375 Location: Japan

Hi GS,

Sorry your mother had to come down with cancer, but the good news is that, as we will all attest to, it is indeed treatable.

Every three weeks is one of the standard treatment regimens (the other being every two weeks, but that is more strenuous and is generally not recommended for older patients) First round treatment is very standardized now, so it should be quite similar to what all of us have received.

As an extra bonus, Rituxan (the "R" drug) is excellent at treating arthritus, so if she's been troubled by that, she may find herself pleasantly surprised midway through her treatment. Smile

Best of luck to you and your mother. It won't be a cakewalk, but it is a very "doable" program, and with the right support she will get through this just fine.
_________________
Age 37 (36 at diagnosis)
Diffuse Large B cell Lymphoma
Stage 1AE (localized in colon)
Began six cycles of R chop 21 3rd Dec 2008
Finished R chop 21 Apr 2009
Complete remission as of May 2009

gs963 · Regular Joined: 27 Jul 2009 Posts: 20

WED was Mothers first treatment with R-Chop. IT went well as far as we know now. Today she had to go back and get a shot. I have told her to write down how she feels each day. This way she will have a record and this may help her in dealing with side affects. She is only on the second day of the pills. Today she told me the only thing she noticed was her mouth was dry. Her spirits so far are good. Im a little concerned about the 5 pills she is taking after reading some post on here. Would it indeed be better for her to break up the pills and slpit them 4 hrs apart?? I am preping my work so I can go home and spend tiime with here. I and figuring that later will be better for me to be there. I assume things will go down hill as the treatments continue. Can anyone give me any idea when the side affects will start to get worse. I want to time it so im there for the worst part of the treraments. She said she will be done with the pills sunday. So from what I can tell that completes the first cycle. Is this correct?

SingleDad · Last edited by SingleDad on Fri Sep 11, 2009 3:32 am; edited 1 time in total

From a treatment standpoint yes but the effects will continue on further...

The steroids give her a lift and should up her appetite but be careful with constipation at her age.

The the coin flips and coming OFF the steroids can be quite a crash and there is risk of the runs....
Easy on the spicy foods, citrus juice etc....
She must maintain her weight and if she's hungry tell to her eat...forget the healthy diet for a bit and hit the treats that are easy to digest but high in fat and protein....if she likes shakes those are excellent but be careful with seeds and grains that are hard to digest.

If she likes juices then she needs to talk to her doc as some juices are counter productive in chemo.....anything dairy is pretty solid unless she has an allergy..

Make it fun to have high value treats around....indulge in the things she loves....

Will keep her spirits up.

Her taste buds will change most likely - for instance I'm a coffee lover but lost my taste for it. It is back however.

How would you characterize her diet?

Also make sure she tells you what her weight change was - she gets weighed each chemo cycle .....so you need to know this one and the next one......and so on...
Do you go with her for each chemo??...I'd tend to recommend it, get engaged with the cancer team and it's nice to have someone to chat with as the time seems to go by slowly.

Good luck, high spirits - don't let her friends moan and groan - it's a drag on her energy..

Everyone is different but the chemo will wear on her energy so keeping her well fed and content now - like she''s getting ready for a marathon is good planning

Many older people are set in their ways on eating etc and what served her when she was healthy is way inadequate now.

Where ever the choice is go for higher calorie/fat/protein....her body will crave it and the worst part her digestion will not be the same so she will not even get the nutriition she normally would - so it's a double edge.

get a handle on the energy/fuel early...it will show up in weight and blood count and energy levels.

Deficits in that management will show up as weight loss, energy loss, and poor blood counts - you need to monitor all of these with her.

and if she's a napper like me - tell her to go for it...sleep is critical...there is a war going on inside her and she needs rest and big time nutrition to deal with it and no stress from "concerned" friends.

You two need a battle plan..and in case if an army marches on their stomach....then she needs her nutrition in just the same way. Mr. Green

Upset tummy - ginger ale, mint tea, ginger candies and they are good for dry mouth..small frequent meals and nibblies and soothing drinks - some of which are high nutrition...some of the commercial shakes - meal in a bottle - out there are good for balanced nutrition - - easy to digest and high value.

Plump rosy cheeks are the goal and happy smile - get you both through this..

This s a somewhat funny pretty accurate account with good info

http://mediastinalwhat.com/_chemo.html
_________________
Age 62
Diffuse Large B cell Lymphoma Stage 2/3
CHOP+R started Feb 26th 2009
Completed 6 cycles June 2009
Diary here http://cancerforums.net/viewtopic.php?t=12003
Officially in remission July 9th 2009 Wink

Three rounds of Intrathecal completed July 29th
Radiation as a prophylactic measure.
1st Radiation Sept 9 completed Oct 1.
Cancer free scan Jan 2010 - remission confirmed
In South Africa for three months

ChemoMan · Posted: Fri Sep 11, 2009 2:03 am Post subject: Re: Stage 2 B cell NHLTreatments.

Hi gs963

Dont play around with the meds , just follow the doctors instructions. good advice about the diary she can take that to the docs and if things need to change the the doctor will give new instructions. As SD said the worst is coming off the pills as it can cause depression, but if your Mum is expecting this it shouldn't be too bad as it only lasts a day or 3 . Response to chemo is very individual and your mum might be OK and not suffer to much in the early cycles. Fatigue becomes a problem at some stage for everybody, especially near the end. Your mother needs to be real careful not too catch colds or flu as her immune system is depressed and even a cold could be fatal. Please don't visit mum if you are sick and give these instructions to all her friends and family.

The first cycle is by far the easiest and each one becomes a bit tougher, however R CHOP is fairly easy compared to other chemo regimes so don't worry too much. At the end of it Mum will be in remission. Very Happy

Good luck and keep us posted.
_________________
Age 53
Diffuse Large B cell Lymphoma
Stage 2a
Finished six cycles of R chop 21 26th May 2008
Officially in remission 9th July 2008
Remission confirmed 1st October 2008
Remission confirmed 17 June 2009
http://cancerforums.net/viewtopic.php?t=9620
RULE NUMBER 1.....Don't Panic
RULE NUMBER 2..... NEVER GIVE UP
RULE NUMBER 3..... Don't forget the first 2 rules

gs963 · Regular Joined: 27 Jul 2009 Posts: 20

Thanks Chemo for the nice words. Yes I think I agree with you on following the Drs orders to the T.I also agree about the easy for her to catch a cold or anything. Im doing the best I can by trying to keep her impformed so she is not surprised buy what her body is doing. Since I cant be there all the time I am trying to time when Im there during her worst times if possible. Of course its hard to really know when that may be. But now it appears toward the end of the treatments may be it. Her 80th birthday is the first week of JAN. We are all hoping we can have a LARGE party. Single Dad, My mom started her treatments at 126lbs.We will be watching the weight for sure. From what I understand the drink ENSURE is a good supplyment for her to drink. I agree with everything you said. Thanks again for everyones input.

SingleDad · Posted: Fri Sep 11, 2009 1:51 pm Post subject: Re: Stage 2 B cell NHLTreatments.

Yes Ensure is full nutrition....she may have some cravings - her body may be looking for protein - fat or trace elements - no harm in treats if easy on the tummy.

126 means not a lot of reserves - what is her general diet like??

Be careful with any vitamins or supplements tho a one a day vitamin is okay.

If she's hungry you have to reassure her that she needs to eat - now is no time for weight watching...

If she's not hungry -then it's really important to get at least something like Ensure going into her diet

Ginger ale is good ..skip the diet version for now - the calories won't hurt.

Lots of sleep, good easy to digest energy food ( pastas etc ) and low stress.

Depression is a real risk ...high spirits = better outcome chances.
_________________
Age 62
Diffuse Large B cell Lymphoma Stage 2/3
CHOP+R started Feb 26th 2009
Completed 6 cycles June 2009
Diary here http://cancerforums.net/viewtopic.php?t=12003
Officially in remission July 9th 2009 Wink

Three rounds of Intrathecal completed July 29th
Radiation as a prophylactic measure.
1st Radiation Sept 9 completed Oct 1.
Cancer free scan Jan 2010 - remission confirmed
In South Africa for three months

gs963 · Regular Joined: 27 Jul 2009 Posts: 20

126 is not much but she is only 5ft 2. I agree with you 100% thanks

SingleDad · Posted: Fri Sep 11, 2009 5:00 pm Post subject: Re: Stage 2 B cell NHLTreatments.

Even so she has not got a lot of reserves to draw on because she is small so a few lb loss needs an eye kept on.

Does she do her own cooking??
_________________
Age 62
Diffuse Large B cell Lymphoma Stage 2/3
CHOP+R started Feb 26th 2009
Completed 6 cycles June 2009
Diary here http://cancerforums.net/viewtopic.php?t=12003
Officially in remission July 9th 2009 Wink

Three rounds of Intrathecal completed July 29th
Radiation as a prophylactic measure.
1st Radiation Sept 9 completed Oct 1.
Cancer free scan Jan 2010 - remission confirmed
In South Africa for three months

gs963 · Regular Joined: 27 Jul 2009 Posts: 20

Sometime she cooks. I will remind he to eat!! thanks

SingleDad · Posted: Fri Sep 11, 2009 6:46 pm Post subject: Re: Stage 2 B cell NHLTreatments.

You have to really convince her how important it is to eat even more than she is used to...get her to understand it's a very important component of the treatment..

The chemo is purposefully destroying her immune system and then her body has to rebuild....it takes tremendous resources not so readiy achieved in an 80 year old....her food is the fuel for that battle and she needs to understand that.

She's not eating more just for enjoyment but as part of her therapy -

The steroids will make her hungry for the first week - tell her not to fight it...

It's after that it might get hard to stay well fed....there is a psychological crash after the steroids, might be the runs ( cuts her nutrition uptake ) and her tastes for things will change.

Two things you really need to know - her weight status and her blood count each cycle.
They will do that when she goes in and you need to know that for your own peace of mind and to help your mum get through it...

Maintain weight, good blood count = successful - her body is doing the job rebooting the immune system and you are doing the best possible thing to help her.

Fuel for the battle.

Once you get into a couple of cycles and she's stable weight and blood work then it's just slogging it out....last couple of cycles she'll be pretty worn down and might even be pretty cranky..I know my staff got the raw end of my temper a couple of times.... ( watch the steroids in that as well )
Now's the time to give her some advantages - mentally and physically.
_________________
Age 62
Diffuse Large B cell Lymphoma Stage 2/3
CHOP+R started Feb 26th 2009
Completed 6 cycles June 2009
Diary here http://cancerforums.net/viewtopic.php?t=12003
Officially in remission July 9th 2009 Wink

Three rounds of Intrathecal completed July 29th
Radiation as a prophylactic measure.
1st Radiation Sept 9 completed Oct 1.
Cancer free scan Jan 2010 - remission confirmed
In South Africa for three months

gs963 · Regular Joined: 27 Jul 2009 Posts: 20

Thanks so much. This is the type of info I needed to know. Be rest assured My mom will fight to win this battle. I talk with her everyday to see how she is and how she feels. I always ask her if she has been eating.

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