Treating Asymptomatic Indolent Follicular NHL?

Don

I drove my oncologist nuts today. This was a follow up visit for a scan done on April 20th and it still showed overall progression, but not as much. Then, I showed him that article from the link I put on a previous post about R-CHOP (agressive) vs R-CVP (non-agressive). We talked about the advantages and disadvantages; then he went on the internet himself to a Professional Web Site and finally said: "If I give you R-CHOP for an indolent lymphoma, I would not be critisized by my colleagues; apparently, there is a move towards that treatment." It gives longer and more complete remissions and there is evidence that it will reduce the risk of transformation to a more agressive lymphoma.

So, he is leaving it up to me. I am still having a "port" installed, echocardiogram, etc. in preparation for R-CHOP, but I could change my mind and go with R-CVP (not as sick, no hair loss, etc).

BIG DECISION!
_________________
Don B
Dec 07 Dx Follicular NHL, Grade I (Indolent)
Stage IIIA - No Symptoms
Watch and Wait - 6 Month Checks
Jan 09 Scan shows Progression - no symptoms
May 18, 09 - Started R-CVP
After Third Round, CT scan showed some tumor shrinkage
July 31,09 - Completed 6 Rounds R-CVP

ChemoMan

Hi

I take it R CVP is RCHOP without doxyrubicin. I love the way you confront the Doctors, there is a lesson there for others Smile

good onya

_________________
Age 52
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..... Don't forget Rule number 1

Don

Well, it has been a while...but I decided to do R-CVP...maybe I am "whoosing-out", but several factors made me decide on that:
1. I am asymtomatic with indolent NHL; normal blood counts and LDH within normal levels. The tumor burden is not very high. I don't need the "big guns" right yet.
2. I am fairly active (61), exercise alot, work outdoors, etc. The "D" (Doxyrubicin) in R-CHOP is hard on the heart and if it did cause problems, it would limit my activities too early in my life.
3. Your body can only take so much of the "D" in a lifetime; and using it early on precludes it's use later should it be needed (I got this from the webcasts).
4. I am a "whoos".
I start tomorrow with the "R".
This past week, I did some long rides on the Harley, and today I split some firewood in preparation for this winter. I still have a lot more to do so I am hoping that the prednesone will give me some boosts of energy.
See you...I'll let you know how it goes...Don B
_________________
Don B
Dec 07 Dx Follicular NHL, Grade I (Indolent)
Stage IIIA - No Symptoms
Watch and Wait - 6 Month Checks
Jan 09 Scan shows Progression - no symptoms
May 18, 09 - Started R-CVP
After Third Round, CT scan showed some tumor shrinkage
July 31,09 - Completed 6 Rounds R-CVP

Don

I was supposed to get just Rituximab today...slowly, and the CVP tomorrow; but since there were no effects with the Rituxan...they sped it up and did the CVP today also. So I don't need to go in tomorrow.

So far so good.
_________________
Don B
Dec 07 Dx Follicular NHL, Grade I (Indolent)
Stage IIIA - No Symptoms
Watch and Wait - 6 Month Checks
Jan 09 Scan shows Progression - no symptoms
May 18, 09 - Started R-CVP
After Third Round, CT scan showed some tumor shrinkage
July 31,09 - Completed 6 Rounds R-CVP

ChemoMan

Hi Don

How did you go ? all is well I hope
_________________
Age 52
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..... Don't forget Rule number 1

Don

Hey, Thanks for asking. The big thing is dealing with the Prednesone "ups and downs". Because they decided to do the CVP on the same day, I had to take all 4 "P" tablets at 3:00 PM and I was kind of wired. But, since I had split about 1/2 cord of wood on Sunday, I was physically exhausted and had no problems sleeping Monday.

Tuesday was different...I "crashed", esepcially after noon and had zero energy. I tried to sleep, but couldn't until I found an old prescription for clonopin that a neurologist had given me before he diagnosed my herneated disc. I took that at 2:00 AM and "peeled" myself out of bed at 9:00 AM (late for me).

Wednesday was nice...I took all the "P" in the morning, went grocery shopping, mowed the lawn, helped my graddaughter with her Math homework, and generally felt fine. I felt myself slow down about 6:00 PM. I bought some ready made meals at the grocery store just in case this happened.

I took the clonopin early last night (as per the nurses instruction) and just got up (8:00 AM). It is a nice day, and lots to do outside. I feel fine, other than the clonopin "fog", which should wear off in a while. I don't have to go to work...so, I'll just take things as they come.

Maybe tonight I won't do the clonopin.

I have cut out the beer for a while.

See you...Don
_________________
Don B
Dec 07 Dx Follicular NHL, Grade I (Indolent)
Stage IIIA - No Symptoms
Watch and Wait - 6 Month Checks
Jan 09 Scan shows Progression - no symptoms
May 18, 09 - Started R-CVP
After Third Round, CT scan showed some tumor shrinkage
July 31,09 - Completed 6 Rounds R-CVP

SingleDad

Isn't preg fun....wow.... Shocked

I've learned to spread mine over 4 hours -

Was not such a buzz this time around - my energy levels were so low -
It 's mid summer temps here today 29 = high 80s and humid so dragging ass...
_________________
Age 61
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 to come as a prophylactic measure.
1st Radiation Sept 9 - 17 does completed Oct 1.
No more treatments scheduled
Heading to South Africa in January - once the itching stops Mr. Green

Don

I feel like a "plant" today...not sick, but I'm afraid someone is going to try to "water" me.
_________________
Don B
Dec 07 Dx Follicular NHL, Grade I (Indolent)
Stage IIIA - No Symptoms
Watch and Wait - 6 Month Checks
Jan 09 Scan shows Progression - no symptoms
May 18, 09 - Started R-CVP
After Third Round, CT scan showed some tumor shrinkage
July 31,09 - Completed 6 Rounds R-CVP

ChemoMan

Hi Don

It will be over soon. good luck with it all. Even with the R CHOP I was surprised at how easy it was to take, I expected much worse.
_________________
Age 52
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..... Don't forget Rule number 1

ChemoMan · Last edited by ChemoMan on Sun May 24, 2009 6:25 am; edited 1 time in total

Hi Don

Hmmm problems with PhP this end
_________________
Age 52
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..... Don't forget Rule number 1

joepet · Senior User Joined: 18 Dec 2008 Posts: 286 Location: Japan

Yes, it's definitely "doable". Less than two months out from my last cycle, the cancer treatments are already a distant memory.

Hope you have smooth sailing with the rest of your treatment!
_________________
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

Don

Hey, Thanks for checking in. I am doing fine. Today was the first day without the Prednesone and I was kind of "there...but not there". The neighborhood pool opened today, so I rode my bicycle up there, hung out with friends, and kind of "vegged-out". It was doing something, without having to do anything.

My appetite is up, I don't really feel bad, I think the Prednesone withdrawal is almost over; when I take a shower I will feel human again. I believe that I will be able to sleep like a "rock" tonight.

If tomorrow is OK, I am thinking of riding down to see my friends with the Harley Owners Group as they start out on Rolling Thunder. We'll see...if I do that, I will have to go to the 7:30 Mass so I will have to get up early. But if I don't, then...I don't.

The two little lumps I had in my groin that I always thought were tight muscle knots are gone...I guess they were not really muscle knots.

Well, see you all later...I haven't yet found any Cooper's Beer...but I'm still looking.

Don B
_________________
Don B
Dec 07 Dx Follicular NHL, Grade I (Indolent)
Stage IIIA - No Symptoms
Watch and Wait - 6 Month Checks
Jan 09 Scan shows Progression - no symptoms
May 18, 09 - Started R-CVP
After Third Round, CT scan showed some tumor shrinkage
July 31,09 - Completed 6 Rounds R-CVP

ChemoMan

Hi Don

hang in there it will be over before you know it Very Happy

_________________
Age 52
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..... Don't forget Rule number 1

Don

Yeah! I slept like a log and got my wife and I went to the early Mass, but when I got home, I felt like I needed more sleep; so I took a nap. It has really turned humid today and I can't really tell if I feel lousy or good. Perhaps I'll go to the pool again and just hang out.

Tomorrow is Memorial Day, a federal holiday, and they are having a cook out at the pool...so I am sure I'll be there. It is a nice neighborhood pool that we joined when we bought our house in 1990. We have been members ever since, our kids were on the summer swim team there and now my granddaughter is, and each summer we always meet up with folks that we haven't seen all winter (our summertime friends). It is really nice.
_________________
Don B
Dec 07 Dx Follicular NHL, Grade I (Indolent)
Stage IIIA - No Symptoms
Watch and Wait - 6 Month Checks
Jan 09 Scan shows Progression - no symptoms
May 18, 09 - Started R-CVP
After Third Round, CT scan showed some tumor shrinkage
July 31,09 - Completed 6 Rounds R-CVP

ChemoMan

Hi Don

No news for a while....how is it going ??????
_________________
Age 52
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..... Don't forget Rule number 1

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