In spring, I came down with a cold which hit me very hard and lingered for several weeks. When I finally thought that was behind me, without warning I awoke one morning with a tremendous inflammation, pain, and soreness in the left shoulder, left side of the neck, and back of the head. The swelling and soreness gradually subsided over the next several weeks, leaving behind a hard tender lump on the left side of the neck. The eventual diagnosis, delivered shortly before the 4th of July, confirmed something that is probably one of everyone's worst fears. Cancer. Hodgkin's Lymphoma.
Chemotherapy was the only feasible treatment because the malignancy had already spread and was in Stage III. I was soon subjected to something known as a MOPP-ABV regimen. This meant, in very simplified terms, that over a four week cycle I would get hit with the MOPP chemicals in week 1, and the ABV chemicals in week 2. My body would then be given two weeks of R & R to attempt to recover from the poisonous onslaught. Then it was back to the next cycle starting over at week 1, continuing for six cycles.
I am not going to go through all of the details and the effects of the various drugs. This is covered in excruciating detail in other places on the web. See, for example, http://www.deltronix.com/public/li/moppabvd.html for a good overview of this subject.
There are just a few comments I want to add about so-called "side effects." Perhaps until one is confronted with the prospect of treatment, little thought is given to the real cause and nature of side effects, which may be viewed as almost amusing incidental curiosities. Everyone knows about hair loss and possibly other things resulting from treatment, but the why? question is overlooked. These events are caused directly by the treatment killing normal healthy body cells in addition to the cancer cells. Certain chemicals are more focused on the cancer than others, and some very effective cancer drugs may be more toxic than others to normal cells. And just as different people with supposedly identical cancers will have varying degrees of success with the same treatment, healthy cells in different people are affected in different ways and to varying degrees. In general treatment often affects cells in hair follicles (causing hair loss), cells in the digestive tract (nausea and vomiting), red blood cells (fatigue), and nerve cells (cramps and joint pain).
A further observation on side effects is that they do not magically go away when chemotherapy ends. As the goal of the treatment is to eliminate the cancer cells so that the cancer is in permanent complete remission, it should not be surprising that enough healthy cells are also killed so that complete recovery is problematical. We want the perfect result: all of the cancer will go away and never return, while everything else quickly returns to normal. It just does not work that way in real life. One of my oncologists discussed with me the dilemma doctors face in treating potentially curable cancers. Obviously, the treatment has to be strong and aggressive enough to wipe out all of the cancer cells, but on the other hand not so toxic that the quality of life after the cancer is lessened any more than necessary.
In any event, in my case the treatment was a success. The visible tumor began melting away within days of the initial treatment. By the end of the second cycle, it had disappeared. The treatment then dragged on for the remaining four cycles in the effort to assure complete eradication of remaining cancer cells. Because of the apparently clear physical indications of success, the oncologist opted not to continue with follow-up radiation (which is frequently used), with its own possible complications. Subsequent CT scans revealed no evidence of a relapse; and once the complete remission passed the five year point, the oncologist started using the word "cured." Hurray!!! Now it is over eight years.
And the side effects? As in most cases, the story is mixed. I did not have total hair loss, which is extremely unusual for this treatment regimen. Nausea was nonexistent, but the steroids I was taking to help the body tolerate the treatment gave me a ravenous appetite, coupled with severe heartburn that could only be alleviated by eating. I gained thirty pounds. This is not unusual. Fatigue became progressively worse. The most troubling side effect, and the one which still lingers, is peripheral neuropathy. Vincristine, one of the chemo drugs, damages nerve cells. It is particularly noticeable in the hands and feet. The initial effect was extreme pain and cramping in the joints, becoming worse with each cycle. What kept me going was the stubborn determination, "I AM going to beat this thing." The lingering effect is a general numbness in some of the fingers and toes and a loss of some dexterity in the fingers compared to pre-treatment days. In other words, my handwriting has become virtually illegible no matter how hard I try.
Overall, perhaps a small price to pay for the new life I have been given. And more than ever before, I appreciate how wonderful that life can be.