Friday, August 26, 2005

Decisions, Decisions, Decisions

After spending the week reading over medical journals on Hodgkin's treatments, I've decided to go with ABVD for my treatment. It was quite hard to make the decision based only on the affects of the treatment, because each negative seemed to have some positive that outweighed it. Going through the medical journal articles, I was able find some that compared the overall success of ABVD and Stanford V directly. Some of the earlier studies only showed that Stanford V was an effective treatment, but the later studies showed that Stanford V was not as effective as ABVD. Over all, rate of reoccurrence of disease seems to be higher with Stanford V, and the long term cure and survivability rates of ABVD are much higher.

The possibility of lung and heart damage still worries me, but I have found some information on the Nation Cancer Institute website about supplements that seem to make the heart and lungs resist damage while taking the drugs that cause it, so I will ask my doctor about that. I still have one more appointment at the UW hospital next tuesday (relating to Meg's concern of not having any little Aarons running around) so I will be starting my chemo next thursday. I've just called them up and let them know, so they will be arranging things and calling me in the next few days to get things set up. I kind of wish I could just start it today though. I'm not as impatient as I was before, but it'd still be nice to get it going.

So doing nothing this weekend. Maybe I'll be able to get my film developed. One is going to be hard. I'll either have to trick them into thinking it's regular film, convince them that developing this non-regular film will not cause their machines to blow up, or take it somewhere that understands ( and charges $20 per roll...)

Sunday, August 21, 2005

Choices, Choices, Choices

Last friday, I had my second appointment with my doctors, and they discussed their findings and the two treatment options. The CT-scan and PET-scan both showed that nothing has gotten worse since my scans in Tokyo, and also that it has not spread beyond my lymph system and spleen. Therefore, there are two ways they can treat me. ABVD, named for the four toxic chemicals they will pump through my body, or Stanford V, named for the five toxic chemicals they will pump through my body, and the institution that developed it.

ABVD is what has been used for Hodgkin's for the last 20 or more years, and is pretty tried and true. It will be 6 courses, lasting a month each, injected every 2 weeks. The side affects are hair loss, nausea, general crappieness, etc. in the short term, and possible heart and lung scarring in the long term.

Stanford V is a newer treatment developed by stanford, but it too has been around for a while. But because of the relative rarity of Hodgkin's, it's still in trails. The main benefit of Stanford V is that it takes only half the time of ABVD. It would be 3 months, with injections every week. The short term side affects are about the same as ABVD, but one of the ingredients is something called nitrogen mustard, a derivative of mustard gas. It was one of the first chemicals used for cancer treatment, but has long since been replaced with others. Now it is back, but in much lower doses. Some of the side affects are sterility and a possible reassurance of other forms of cancer. In the old days, this would be about a 15% chance. With the Standford V, my doctors have said that it's probably 1 to 2%, and sterility is also uncommon. Also, with Stanford V, less of the chemicals that could cause heart and lung scarring are used in lower doses.

The nitrogen mustards sound pretty ugly, but really, it's a pretty close call. ABVD has been successfully used for a long time, but its 6 months and has a risk of scarring, while Stanford V is much quicker and has a lower risk of heart and lung scarring, but has a tiny chance of causing a secondary cancer.

I am worried about the possible heart or lung problems, and I like the 3 months vs. 6 months of the Stanford V, but I don't like the 1 to 2% re-occurance rate vs. .1% of ABVD. So right now I'm still trying to decide between the two. Treatment will probably start friday.

Tuesday, August 16, 2005

Seeing People

I finally went to see some doctors last friday. I am going to the Seattle Cancer Care Alliance, which is a building on the corner of the Fred Hutchinson Cancer Research Center on Lake Union in Seattle. I have two doctors, one who is staff at the Cancer Care Alliance, and the head doctor, Stephen Petersdorf, who is a professor of Oncology at the UW. Last friday, we talked about the disease, treatment, and got some more tests and a CT-scan done.

This week, I will have 3 appointment, including a PET-scan at he UW Medical Center, and an appointment to finalize the treatment plans. Probably, I will start treatment by next week. I'm happy about deciding to come here because I think its the best possible place I could choose to have treatment. I don't like how long its going to take, but I have no other choice but to stay and finish everything before I get my life back on track.

I have a bunch of film sitting in the fridge, so if anyone knows someone with a negative scanner, let me know. I had to leave mine in my apartment in Tokyo.

Monday, August 08, 2005

Going somewhere

I haven't updated in a while, because there's really been nothing happening since Ai left a weeks ago. I've been hung up on trying to get copies of the biopsy slides from my hospital in Tokyo. The oncologist here said it would be much quicker to wait for them than start over here, but I was starting to have doubts. My doctor here emailed the doctor in Tokyo asking him to FedEx them, but when Ai called last week, she found out that he was on vacation, but was assured that he'd send them as soon as possible. The really frustrating thing is that I asked him for all this stuff weeks ago, but he said some of it would take too long. Apparently he only did the stuff that he could have done the next day for me to pick up before I left for Seattle. So he's finally sent them, and they arrived at my oncologist today, so I finally have an appointment this friday. Hopefully, I'll be able to start my treatment next week.