The Anticipated Staging Results are Here!

Today was a big and eventful day! I got the results of all the numerous tests I had been doing all along. I am sure you will recall how anxious I have been to know how far the cancer had spread. Thank God! its Stage I - II and referred to as early stage lymphoma! Its funny that on receiving the news, I felt ambivalent. Just that state of having simultaneous, and unexplainable conflicting feelings. Suddenly, after learning the stage of my cancer I did not feel that excitement one would expect given I am a Stage II not a Stage IV - I know it could have been worse.  But, guess what, the struggle continues. Aluta Continua! Anyway, call me a cynic - I don't see the reason for celebration yet, because I am still inducted in the "Hall of Cancer" despite being in the early stages. It does not change the overwhelming emotions and fear of the unknown let alone the aches and pains. Don't get me wrong, I appreciate that it could have been worse but please, does that change my situation? Certainly not! I still feel crappy about this whole journey. Don't worry people, chemo is going to knock some sense into my head, so I am told. By the way, before I saw the oncologist, I had the good pleasure of meeting my pleasant oncology nurse/case manager who will be working with me and at my disposal 24/7. Of course, not literally. Well, we spent a good half hour doing the blah, blah, blah blah of chemo side effects and how I may need to purchase a children's very soft toothbrush because my mouth will become tender, sensitive and develop mouth sores the most feared side effect of chemo. And blah, blah blah, its better to cut your hair so you don't experience the emotional toll of it falling off in the shower or everywhere.

My Hodgkin's lymphoma diagnosis has been staged and is classified as Stage IIA ("A" means no symptoms of unexplained fever, night sweats etc). Hence, this is considered early stage cancer which is good according to my doctor. I do not have any "B" disease which means "bulky disease". I have multiple enlarged lymph nodes in my neck and a few mild enlarged lymph nodes in my chest. Bulky refers to cells greater than 10 centimeters in diameter and require more chemo. The only downer is that the doctor explained that apart from the initial large tumour cells on my neck, the results revealed more tumor cells on the left hand side of my chest. which require further investigation.What that means is that I have to go back to the place I hate so much - the nuclear place to do this urgent special test called Gallium scan. The Gallium scan is an important indicator of Hodgkin's activity in the identified tumours in the left side of my chest.

Let me give you a brief overview of how Hodgkin's is staged into different groups. Remember earlier in my blogs I mentioned that Staging helps determine prognosis and treatment options. Hodgkin lymphoma stages include:
Stage I - means that the cancer is limited to one lymph node regions or a single organ.
Stage II - means the cancer is limited to a section of the body either above or below the diagram.  In this stage, the cancer is affecting two different lymph nodes or the same side of the diaphragm.
Stage III - the cancer has moved to lymph nodes both above and below the diaphragm or its in the spleen.
Stage IV - This is the most advanced stage of this type of cancer. It means cancer cells are in several parts of one or more organ tissues. In this stage, the lymphoma affects both the lymph nodes and other parts of the body such as liver, lungs and bones.

My treatment plan involves 4 cycles of chemo in combination with radiation to the areas of the involved lymph nodes instead of the traditional 6 cycles. Each cycle is broken down into two - meaning one cycle will be administered as an outpatient twice in one month with a two week break in between to allow the blood counts to recover. The A, B, V, D will be administered through an intravenous line. I got a whole bag of different prescriptions to take prior chemo to manage the common side effects such as nausea, etc. Given the very nature of chemo and its potential to destroy both good and bad cells, the two week break in between is kinda like a holiday for me to build strength to take in some more chemo. The radiation treatment plan will only occur after the 4th cycle under a different radiation oncologist who will determine how many cycles. I believe the radiation will be targeted to only the parts of my body known to have the cancer (like its some kind of relief).