After 2 weeks of waiting and testing I was ready to meet with the Oncologist to discuss treatment. At this point, I was anxious about treatment, but really wanted to start treating the cancer that was attacking me. The testing revealed that the lymphoma was Stage 1, which was relatively uncommon for Non-Hodgkin’s lymphoma. This meant that the cancer was limited to the lymph nodes in my neck. The MRI didn’t show any signs of the cancer spreading to my brain, the bone marrow looked good, and the PET scan only highlighted the neck. The pathology was still unclear, however, so they weren’t sure if it was “Burkitt Lymphoma”, or a high grade B cell lymphoma that was “Burkitt-like”. The treatment for Burkitt lymphoma is typically R-EPOCH, which is chemo given over a 96 hour infusion. The treatment for a more standard B cell lymphoma would be R-CHOP, which uses similar drugs, but is given in one day (except for the prednisone, which is given over 5 days in either case). In any case, there are plusses and minusses with each, but R-EPOCH is considered the “big hammer”. The Oncologist suggested this as R-EPOCH works in either case, however R-CHOP may be insufficient if it turned out to be Burkitt Lymphoma. I told him I was ready to start as soon as possible.
In order to start treatment, I would need either a PICC-line, or a Port. As explained to me, the PICC line was a bit less invasive. For a PICC line, I would need to visit the hospital, where they would feed the line through a vein in my arm up to an area just outside my heart. When treatment was complete, they could remove the PICC line at the Oncology facility. The port would be more invasive with a surgery required to put it in as well as take it out. I went wit the PICC. I did not experience a port, so I can’t really make a fair comparison, but if I could go back, I think I would have gone with a port. I had a LOT of trouble with my PICC line. I was constantly fighting with irritation around the PICC. The nurses were great and tried everything to keep it under control, but it was an ongoing fight. Also, I really felt like the PICC limited my activity through my treatment. My treatment went through the summer, and the slightest outdoor activity would bring on the sweat, making the PICC line maintenance that much tougher. In any event, I was scheduled to have the PICC line inserted the next Monday (4/6) and would begin chemo the next day (4/7).