THURSDAY JUNE 20th, 2019
Compared to yesterday, today was much more tame.
Unfortunately, Chris woke up with pretty significant double vision. After speaking with the attending oncologist, an opthamalogy consult was ordered. While waiting for the opthamologist to come, he had a good amount of visitors, and was kept busy almost the entire day.
The opthamalogist did a full blown eye exam on Chris with a couple extra bells and whistles added on. He determined that Chris's double vision was likely caused by a "stroke" to his 6th cranial nerve (6th cranial nerve palsy). Because of the chemo, Chris's hemoglobin is low again and the opthamalogist believes that this is the cause of the nerve palsy; typically this resolves on it's own. The eye exam was otherwise unremarkable and the opthamalogist will check back in next week.
Other than that, it was a pretty uneventful day (finally!). Chris seems to be tolerating the chemo well and the results so far are as expected. No nausea symptoms thanks to prophylactic zofran. Chris is trying to do whatever he can to help the process along, which means drinking lots of water, trying to be active and up and walking, and eating well so his body has the calories to handle the chemo. Hopefully this will be the case in the days to come as well!
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I realize that some of the information that I gave yesterday was pretty vague, so I just wanted to expand a bit for those that might be interested.
As stated previously, Chris has stage four MYC positive Non-Hodgkins Lymphoma (Diffuse Large B-Cell Lymphoma). MYC is a potent oncogene. MYC gene alterations have been identified in other mature B-cell neoplasms that are usually associated with an aggressive clinical behavior. (https://www.ncbi.nlm.nih.gov/pubmed/24009228)The MYC protein controls cellular functions such as differentiation, proliferation, and apoptosis. In response to genotoxic agents, cells overexpressing MYC undergo apoptosis.
The typical chemo regimen for regular NHL is called R-CHOP (an acronym for the drugs given). Because Chris has the MYC oncogene, he is on a regimen called R-EPOCH. Both regimens are given over several days with 21 days between cycles.
R-EPOCH includes an additional drug, Etoposide Phosphate. The Etoposide is given specifically to target the oncogene.
The rest of the Drugs included are:
R = Rituximab ( Specifically targets B-cells)
E = Etoposide Phosphate
P = Prednisone (helps with the treatment of nausea and inflammation)
O = Vincristine Sulfate (Oncovin)
C = Cyclophosphamide
H = Doxorubicin Hydrochloride (Hydroxydaunorubicin)
Chris will be receiving 6 cycles of this regimen. A cycle consists of 5 days of treatment, followed by 21 days of recovery. He will have a PET scan done after the second cycle to assess his progress.
That's all I've got for now. Fingers crossed that tomorrow goes as well as today.
Thanks, as always, for the continued love and support.
V
Compared to yesterday, today was much more tame.
Unfortunately, Chris woke up with pretty significant double vision. After speaking with the attending oncologist, an opthamalogy consult was ordered. While waiting for the opthamologist to come, he had a good amount of visitors, and was kept busy almost the entire day.
The opthamalogist did a full blown eye exam on Chris with a couple extra bells and whistles added on. He determined that Chris's double vision was likely caused by a "stroke" to his 6th cranial nerve (6th cranial nerve palsy). Because of the chemo, Chris's hemoglobin is low again and the opthamalogist believes that this is the cause of the nerve palsy; typically this resolves on it's own. The eye exam was otherwise unremarkable and the opthamalogist will check back in next week.
Other than that, it was a pretty uneventful day (finally!). Chris seems to be tolerating the chemo well and the results so far are as expected. No nausea symptoms thanks to prophylactic zofran. Chris is trying to do whatever he can to help the process along, which means drinking lots of water, trying to be active and up and walking, and eating well so his body has the calories to handle the chemo. Hopefully this will be the case in the days to come as well!
---------
I realize that some of the information that I gave yesterday was pretty vague, so I just wanted to expand a bit for those that might be interested.
As stated previously, Chris has stage four MYC positive Non-Hodgkins Lymphoma (Diffuse Large B-Cell Lymphoma). MYC is a potent oncogene. MYC gene alterations have been identified in other mature B-cell neoplasms that are usually associated with an aggressive clinical behavior. (https://www.ncbi.nlm.nih.gov/pubmed/24009228)The MYC protein controls cellular functions such as differentiation, proliferation, and apoptosis. In response to genotoxic agents, cells overexpressing MYC undergo apoptosis.
The typical chemo regimen for regular NHL is called R-CHOP (an acronym for the drugs given). Because Chris has the MYC oncogene, he is on a regimen called R-EPOCH. Both regimens are given over several days with 21 days between cycles.
R-EPOCH includes an additional drug, Etoposide Phosphate. The Etoposide is given specifically to target the oncogene.
The rest of the Drugs included are:
R = Rituximab ( Specifically targets B-cells)
E = Etoposide Phosphate
P = Prednisone (helps with the treatment of nausea and inflammation)
O = Vincristine Sulfate (Oncovin)
C = Cyclophosphamide
H = Doxorubicin Hydrochloride (Hydroxydaunorubicin)
Chris will be receiving 6 cycles of this regimen. A cycle consists of 5 days of treatment, followed by 21 days of recovery. He will have a PET scan done after the second cycle to assess his progress.
That's all I've got for now. Fingers crossed that tomorrow goes as well as today.
Thanks, as always, for the continued love and support.
V
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