Drugs! ABVD Chemo Guide for the Newly Diagnosed

I start ABVD Chemotherapy tomorrow, for my first treatment in cycle 1.  I have 4 cycles (4 months), which is 2 treatments per cycle every 2 weeks.  2 week break after chemo. Followed up by 4 weeks of radiation treatments.

Chemotherapy is the term for drugs used to treat cancer, but depending on what type of cancer you have- the drugs (and side effects) vary greatly.  ABVD is the typical chemotherapy regiment used in treating Hodgkin's Lymphoma. 

If you're newly diagnosed, you probably found this site doing a search, and have no idea what chemotherapy entails, and what you do know unfortunately comes either from TV, or seeing a family member go through it with a different form of cancer- no one wants to go through chemo  but ABVD is not a "waste away" type of regiment, it won't make you a bed ridden mess who can't see sunlight for 8 months. No one wants cancer, but the cancer you have- if you had to pick one, it's the one to have.  The treatment side effects are relatively minimal compared to other chemo treatments, and the success rate is very high.  Let me go in depth into what it is; ABVD stands for the names of the drugs and the order they're given in (hence why they're not in alphabetical order):

Technically- there's 6 drugs +  a couple of tests + things to do before starting treatment;

• Sit in a cozy reclined leather chair.  As it typically takes 3 1/2 hours to administer ABVD.  I'll have plenty of snacks (sour candy!), lunch (or breakfast depending on the time of day you get treatment), water (ALWAYS bring water with you), even coffee (I'm a coffee fiend), books, and a smart phone with internet- so I shouldn't be bored. I start at 10 AM, and should be done about 1:30 PM. 

• Blood Tests: Since I have that easily accessible port in my chest, they will begin with doing a routine blood draw.  To check for a multitude of things, mainly: platelets, red blood cell levels, white blood cells, and a few other tests.  Mainly to see how I'm responding to treatment side effects and getting a baseline before treatment starts.

• Pegfilgrastim:   Is a drug to stimulate white blood cell growth in the body, to fight infections etc, as during the ABVD treatment, the immune system becomes weakened (which is how it works).  Typically given via IV during treatment.

• Anti Nausea Medication:  There's a couple of drugs I could possibly get.  As one of the major side effects of ABVD is nausea. ABVD targets fast growing cells within the body and kills them- which is basically the cancer cells.  However- other "fast growing" cells within the body are hair cells (why hair falls out with chemotherapy), and stomach lining which causes nausea. Also- taking anti nausea drugs AFTER you're nauseated isn't the way that works, it needs to be taken before (if you were wondering).

• Adriamycin: The nurse "pushes" it, meaning it's slowly injected into my IV port.  It's BRIGHT red, and you can imagine what color my urine will turn after that, which I'm told causes no problems- other than shock value (don't worry I won't post pictures of that).  It's the drug that hits the cancers cells the hardest, and is used in many other treatments of cancer like breast cancer.  One of the side effects of it- it will give you a bad taste in your mouth.  MANY people have told me: do NOT eat anything you like on treatment day, or a couple of days after- as it will taste horrible, and you will forever associate that food with chemo.  Many people have ruined their favorite foods for life because they didn't take that advice.  So newly-diagnosed-person: eat things you don't care about the day of and 2 or so days after until you feel better.  Seriously.  During treatment, bring a hard sour candy to suck on- helps with the taste.

• Bleomycin: or “Bleo” as people call it. It's also pushed via syringe. It's clear, and VERY rarely people have an allergic reaction to it, so the nurses will test out a small dose to see if that's the case before proceeding. It can cause some pulmonary lung problems in some people, but that's why I'll have constant pulmonary function test to see if my lungs are okay during treatment. My anesthesiologist was impressed by my lung capacity during my lymph node biopsy, usually they have you count down from 10, I never got there as I took a DEEP breathe and was out immediately (I was told he giggled at that, as it doesn't happen often)- so I'm pretty healthy and my lungs are great.

• Vinblastine:  Most people do not have a problem with it, and it's also pushed through a syringe.  It has no side effects during administration.  It could have possible side effects to the nerves later down the line, but it's the "easiest" to take.

• Dacarbazine: This is the worst (and saved for last) drug to be administered. It's administered via an IV drip, and takes at least an hour to administer fully. However I have a port, so it should speed things along. This is what causes the nausea. Having that anti nausea medicine will help GREATLY with this drug.

Also new people: If you are given the choice of a port or no-port, take the port. Sure it's weird having a thing in your chest, but your arm veins will thank you, the nurses will thank you, and it will speed up the whole process in general- as no one wants chemo treatments to be longer than they have to be.

After treatment- you're free to go!  And yes, you/I are certainly capable of driving after.  The night of though, and about 2-4 days after:  You'll/I'll have nausea, fatigue  because of the lowered white blood cells- once the start generating again after those few days, you'll start to feel better.  Think of it as "one week down, one week up" cycle.  Because when you're recovered from treatment, it's time for the next one.  As treatments go on, the "down" lingers a little longer.  After 6-8 treatments many patients hit a wall, however- I only have 8 treatments, so I shouldn't be too bad off.  Oh yes- your/my hair will fall out slowly over treatment.  Many people shave their heads, not because it all falls out- but because they're shedding everywhere and look mangy, in other words: it's annoying to leave it in and better to just chop it.  I'll post about hair loss in the future (I plan on getting mine cut very short soon).   It should be mentioned- that ALL of you hair will thin, eyebrows, eye lashes- the whole bit.

For me personally- I'm healthy (all of my blood levels are in the exact median- whoo-hoo!) and young (33... that's "young!"), so my side effects from treatment shouldn't be too rough, and side effects should be minimal. However: EVERYONE is different, and side effects are too.  You/I will just have to see how it goes during treatment.  Age and general health are key as well.

Oh and a cat.  This is Elli (Miles is the other one).  She's my... "simple cat."  Here she is doing her Jabba impersonation: