Side Benefits

The pharmaceutical companies do a good job of warning (and terrifying) us about the harmful side effects of chemo drugs. If we spent too much time dwelling on the long list of negatives, we might be tempted to say "f'get about it," but that's not an option for most cancer patients.

But the drug companies don't tell us about the harmless side benefits. I recently wrote that new friends (both online and offline) are one of the positive perks of cancer treatment.

I just discovered something even more tangible.

In my BC (before cancer) days, I had a gimp right knee that sometimes collapsed mid-stride. If I walked as little as one mile, I spent the next two days limping like Chester, the Dennis Weaver character on Gunsmoke. (Oops, I'm dating myself.) An orthopedic surgeon and an MRI confirmed in January '07 that I had osteoarthritis. (Now I'm really dating myself.)

But a curious thing happened after I began cancer treatment: My knee healed. (I guess it would be more accurate to say that I became "symptom free," but that doesn't sound as dramatic, does it.) I could take four-mile mountain hikes without limping the next day. I could do deep knee bends and lunges. I could even sit in a lotus position in yoga class, pain-free.

About three months after my stem cell transplant, I started to feel the familiar creaks and twinges of arthritis again. Right about that time, I went in for my dose of maintenance Rituxan, a monoclonal antibody that I think of as my relapse prevention drug. The next day, I had the pain-free, creak-free knees of a thirty-year old. I learned that Rituxan is often used for the treatment of rheumatoid arthritis, but it apparently does wonders for osteoarthritis too.

I can look forward to the side benefit of youthful knees for the next two years, thanks to quarterly infusions of Rituxan. While I'm roaming the planet, I may even climb a mountain or two.

A Spoonful of Atavan Helps the Medicine Go Down

Most of you know that I've completed two of eight rounds of Rituximab + Hyper CVAD. I haven't mentioned that the protocol consists of alternating courses of "A" and "B." For my friends who are addicted to "Discovery Health," ER and every medical show on TV (you know who you are), I'm going to do something uncharacteristic and list the drugs in each course. If this level of detail makes your eyes glaze over, simply skip this post.

Course A is as follows:

* Rituximab (aka Rituxan, a monoconal antibody) at 375 mg/m2 on day 1 of each cycle
* Cyclophosphamide at 300 mg/m2 IV over 3 hours every 12 hours for 6 doses on days 1, 2, and 3
* Methotrexate at 12 mg IT on day 2
* Doxorubicin at 40 mg/m2 IV on day 4
* Vincristine at 2 mg IV on days 4 and 11
* Dexamethasone (steroid) at 40 mg/d PO/IV on days 1-4 and 11-14
* Cytarabine at 70 mg IT on day 7

Course B is as follows:

* Rituximab at 375 mg/m2 on day 1 of each cycle
* Methotrexate at 1000 mg/m2 IV over 24 hours on day 1
* Leucovorin at 25 mg/m2 IV, 24 hours after the completion of the methotrexate infusion, every 6 hours for 6 doses
* Sodium bicarbonate at 600 mg PO (starting day before methotrexate) 3 times day for 4 days
* Cytarabine at 3 mg/m2 IV over 2 hours every 12 hours for 4 doses on days 2 and 4

This listing doesn't include the "pre-meds," such as Benadryl, which is administered as a drip prior to receiving Rituximab, or any of the anti-nausea medictions, such as Atavan. All of these, by the way, send me straight to slumber land.

Dr. Forman and I have both come to the same conclusion: Course "B" has been much tougher on my body than Course "A."