To radiate or not to radiate...that is the question

Hi strangers!

It's been a little while since my last update. Here's what's been going on the last few weeks:

Two days after chemo #10, I had some major vein pain near where the IV was administrated. This has happened from time to time throughout chemo, but never as bad as this time. Adding to the misery was a huge oval-shaped rash that developed that was about 5 inches long and 3 inches wide. I called Masonic right away, worried that this could be tissue damage as a result of Adriamycin. They said this would be unlikely, as tissue damage would happen when the drugs were actually being administered. Phew! The most likely culprit was either some sort of infection (which was quickly ruled out, as I did not have a fever) or just plain ole vein irritation. Bingo!

In addition to the rash, which lasted two more days, I developed even more bruising and a few welt-like things on my skin. The pain was also very intense for another week. Needless to say this was my worst vein experience yet and I have officially declared my right arm OFF limits for the rest of chemo.

Some more updates:

• I had another pulmonary function test to make sure the Bleomycin hasn't totally warped my lungs. My lovely friend Heather who was visiting from DC accompanied me to the test and was a great support as I freaked out about how much I hated this test. I'm happy to report things went well and my lungs are doing just fine. My lungs were at 95% at my first PFT. My second test showed them at 88%, and my final one stayed at 88%. For comparison, anything above 80% is considered healthy. So, I'm doing okay on that front!
• On January 21, I received chemo #11, which was a breeze in comparison to the last round. The nurse made sure to use my left arm this time, thank god. A quick IV in and we were good to go (and no issues afterward)! My sister Rachel accompanied me for this round of chemo, and boy, is there something to be said for the power of genetics! The Kalaidis family has a very keen sense of smell (it must be our big noses), and right away she complained about the sterile smell of the chemo ward. As I've mentioned before, I haven't really gotten full on nauseated, but I do get queasy/grossed out with the particular smell of antiseptics and saline. Hypochondria also runs in the family. After my oncologist checked my neck/collarbone area to make sure they were free of nodes (they were), Rachel immediately began her own self-examination and almost ventured so far as to ask for her own exam. You know, just to be safe and all.

All in all, chemo #11 was one of the easiest treatments I've had so far. They say the effects of chemo are cumulative, but that hasn't really been my experience. Instead, I've had a few random not-so-great chemos with not-so-great side effects that have been scattered throughout. I guess I can't complain if I'm one chemo away from being done with treatment and still feeling pretty normal!

Before I leave you on that happy, optimistic note, I have one other area I want to discuss: radiation. At my first meeting before I even began chemo, Dr. Peterson laid out my treatment plan: 6 months of ABVD and likely no radiation. He stressed that this was not set in stone -- never say never in the world of medicine -- but given the characteristics of my cancer (smaller tumors spread out around my chest and neck, rather than one or two bulky tumors), Dr. Peterson felt that radiation would be of little benefit to me and could bring a lot of adverse side effects, such as thyroid malfunction, lung/heart issues, and secondary cancers. 

At the time, I was happy to hear this. Yay, less treatment! Not only would I be done sooner, I'd avoid even more potential complications from treatment! 

Well, a study I came across last week has made me question my opposition to radiation. The study found that the most recent trend of treating early-stage Hodgkin's (stage 1 or 2) with chemotherapy only, rather than chemo + radiation (which used to be the norm) has actually had an adverse effect on survival rates. For instance, Hodgkin's patients at 2A (what I was staged as) either receive 4 cycles of ABVD + radiation or 6 cycles of ABVD and no radiation. In the last decade or so, more and more oncologist have recommended option two (which also so happens to be my treatment plan). Yet the survival rate for chemo + radiation is 84.4%, compared with 76.4% for those who received chemo only. 

While this isn't a huge difference, it's significant enough to make me think I might want to get a second opinion, just to be safe. I completely trust Dr. Peterson and think I will probably still stick to the game plan and avoid radiation, but just having the peace of mind of another expert's opinion will make me feel better about everything, though from what I've read over on the Hodgkin's lymphoma message board, oftentimes oncologists put the ball in the patients' court when it comes to radiation, which I guess is both a good thing and a bad thing (good, because freedom of choice! bad, because freedom of choice!).

There have been a few times in my life where I've had to make a big decision where I've wished I was born in North Korea so I wouldn't have to make my own decisions, ergo it wouldn't be my fault if I chose the wrong one. Let's just say Pyongyang is looking pretty good right now...