I made an overview of the chemo treatments that I will undergo. The first two courses will take place in the Jeroen Bosch Hospital (JBZ). The d’s represent the days on which the admission of the respective agent happens. Progressive disease (PD) means an increase in tumor size or the appearance of any new lesion; SD is stable disease, a relapse means the recurring of disease after it disappeared. Depending on my condition and the results of my blood tests, I might be able to go home some weeks during the treatment.
I looked up the chemo-agents, and I was surprised to find that they were all super old. Methotrexate is from 1947, Teniposide (Vumon) from 1984, BCNU (Carmustine) from 1971 and Cytarabine from 1960. Their mechanism of action is different, but they all have the same outcome, killing cells that divide. Because cancer cells divide rapidly, they are killed during the time that these chemotherapeutic agents are at toxic levels in the body. Due to this cytostatic effect, the most common side effects are due to the death of healthy cells that divide rapidly. These are cells such as blood cells in the bone marrow, cells lining the mouth and gastrointestinal (having to do with the digestive organs, particularly the stomach, small intestine and large intestine) tract and hair follicle cells (this is why patients can lose their hair). The second and third part of the treatment will take place in Amsterdam at the VUmc, specifics of this section of the treatment still need to be decided.
The MRI of yesterday does not show any difference in the sizes of the lesions compared to the MRIs as far back as the 7th of April. They explained to me that this could happen with lymphoma, and this does not mean that treatment isn’t necessary. I did send my hematologist a message, wondering whether this does not imply that the cells do not divide rapidly and would therefore not be affected by the chemotherapy.