Hi DI,
Sorry I see this so late. The first phase is very hectic and your husband will be under crazy mental stress.
It happened to me recently.
In this state of mind we are very vulnerable and easy to abandon rational thinking. Many if not most people go in an irrelevant direction that is some cases is also dangerous.
I would advise to help him reach the same conclusion I reached in the first week: The fact that I was unable to make any rational decisions for several months until I come to terms that I have cancer, and my life has changed. The other part is addressing the question of 'why me' which is haunting and burns pretty much all the available mental capabilities.
The other problem is the inability to make any medical decisions. I can tell you what my opinion on all this is and this is a personal opinion that might be right or wrong. Consider this as a freedom as expression information coming from somebody that is a patient and spent time trying to make sense of all this.
Before getting into that a couple of facts that are relevant for this type of cancer:
All or virtually all lymphoma patient are phase 3 or 4. Should you be told you have phase 2 ask for a second test because you were mostly likely misdiagnosed. This information is pretty much irrelevant as far as the diagnostic is concerned so dwelling on it is useless.
Lymphoma is an indolent cancer which after taking away the pompous talk means is slowly developing. The current average life expectancy is almost 10 years. As with any average it really means that we can die in a couple of years or live for 30 years. Of course we would like to think we belong to the last category :)
Lymphoma as pretty much all cancers is incurable. Don't believe people that say cancers are curable. They are virtually not. For people that can use radiation or surgery it means postponing the return of the cancer for a period of time after which it returns. That is due to the mechanisms that govern the cancer.
It usually does not mater too much who is your oncologist initially. If the symptoms are life threatening like fever you have to start a treatment. If not you can choose to wait or to start a treatment. No choice there.
If you have no choice or decide to start a treatment it will inevitably include Rituximab. That is a drug approved in US in 1970 (or something around that) and it's one of the first truly genetic drugs in the world. The patent is due to expire on this drug so the company is in third phase trials with second and third generation similar drugs. You are Australian so unless you find a way to push the government you will not have access to either second or third generation.
Traditionally the treatment also includes CHOP which means Chemotherapy. There are a lot of discussions out there is there is life worth living after CHOP. I personally am trying to avoid this as hell because is irreversible. If you have no chance and take it consider a sperm bank visit.
If you could get on a Bendamustine trial instead of CHOP it might be good. I would do that if I were to believe that a form a chemo is necessary.
Both Chop and Bendamustine are chemotherapy, the doctors don't know why it works and in principle kills cells. In the process it kills a lot of cancer cells and other completely unrelated cells. Thats why you loose your hair etc. Bendamustine has been in use since the late 60s and it has less secondary effects. Because it was produced initially by Eastern Germany US and EU companies could not easily make money from it's commercialization because they could not take a patent. That kind of speaks volumes about how pathetic the Cancer patients are cared for. At this point it has been in trials pretty much all over the world for several years including in Australia.
If I would have not threatening symptoms I would just go for Rituximab. Unfortunately the system does not pay for it unless you also do CHOP or Bendamustine so you will have to fork about 8000 (I was told) from your pocket. I guess this will drop to a couple of thousands once it runs out of patent in less than 2 years.
The thing I would recommend the most is to request of a gene expression test done on the biopsy. They will probably say that is done only in research so they will not do it and in my opinion that would pretty much destroy your chances for the future.
A word about coping strategies:
Some people turn to religion
Some people turn to meditation
Some people turn to sports and exercise
Some people turn to healthy diets and herbal medicine
Some people will deny that they have the disease
Some people will go into weird remedies
Some people will turn to some form of violence
Some people will try to understand the disease
Some to a combination
All these strategies work in the sense of giving your husband and you the peace of mind.
Most of these will make no difference to the disease.
A word of caution: Ritaximab is a MAB type of drug that pretty much uses some things called antibodies to attach to B cells (antigens in this case). The attachment usually triggers a mechanism that kills the B cell. That means that this drug kills B cells indiscriminately so bad and good cells. This is much better than chemo but is still not specific enough to kill only cancer cells.
Once you finish this phase we can talk more.
All the best to you,
Koala
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