My wife is suffering with "HODGKIN's DISEASE" Stage 4AES

[babu57]

Hello Doctor,

My wife aged 55, weight 42 kgs has underwent ABVD chemo sessions of IA,IB,IIA and after which due to drop in WBC count she has been given PEGEX 6mg injection. She is suffering with pains in legs, head, cervical region, waist , loose motions, all these are once in a while say after 5-6 days of each chemo session, Happy to say that she is not having any other symptoms and is able to do household works easily. But how to know whether her disease is cured off or not? How many cycles of chemo are needed for compulsory in her case? Is the condition so critical???

Initially before starting chemo her weight is 40 kgs stable for 3-4 months, and she suffered alot with cough, fluctuations in fever, loss of appetite, sleep disorder. But however with the usage of "Wysolone" (40mg) tablet before starting of chemo sessions, she became quite normal at time of very first chemo session.

A revert is highly appreciated , as I was unable to know about and get a clarity of the health situation of my wife.

Thanks.

[kontak TeamBCI]

Hi babu57 - its literally very sorry to hear about your wife and her suffering. Lets wait for Doctors advice.

[kontak TeamBCI]

Hi babu57 - literally sorry to hear the pains your wife is suffering. Lets wait for Doctor to advice

[sumeet_shah Administrator]

The best person to answer your question is your Medical Oncologist. You can discuss with your Medical Oncologist, as to whether the responses to chemotherapy have been good or not. They often do serial PET scans to check the status of the disease, if there is a doubt.

As for the side effects, most people undergoing any form of chemotherapy for any type of cancer, do have weakness, bodyache as common side effects. They usually settle off with time. In this climate, ensure that you keep your wife adequately hydrated. If she is aboe to do routine activities, it is very good. Keep her engaged in light work at home, she will surely be better off with that.

[babu57 in reply to sumeet_shah]

Sir,

Its good to see a revert from you. But please clarify after how many chemo cycles can we ask our medical oncologist for a pet-ct scans. As far as discussion with our treating medical oncologist, the doctor was not saying anything to us even reports of CBP and other blood tests which were done at each chemo session were also not being given to us. Hence I am worried much of her health condition.

1.Is stage 4AES of Hodgkin's disease so advanced one?

2.Our doctor advised a 6 cycle ABVD treatment, Is 6 cycle compulsory needed or is there any chance of reduction in cycles after serial pet-ct reports?

3. At what intervals serial pet-ct scans are advised?

4. For pains "Ultracet" tablet is suggested by our oncologist, but is there a long-term or short-term side affect of using it much?

5. A dose of "PEGEX" is useful for how many chemo sessions?

6. Finally recently she lost her hair , do protection for scalp needed? If so what precautions need to be taken? What would be the side affects?

Thanks if you could clear all my doubts regarding chemotherapy sessions.

[sumeet_shah Administrator]

1. Stage 4 for any cancer means an advanced stage. But in many cancers, like for Hodgkin's, there can be a good response to chemo.

2. 6 cycles are needed for all cancers. It is because of the way chemotherapy works. Lesser cycles may not kill cancer cells adequately and more cycles may result in toxicity.

3. Serial PET will be decided by your Oncologist. I am not the right person to answer that, since I am a Surgical Oncologist. Hodgkin's disease is purely a Medical Oncologist's domain.

4. Ultracet is a fairly safe medicine. Don't worry. Ensure that your wife is free of pain.

5. I do not know protocols for PEGEX

6. I do not think scalp protection as such is needed. But she may be more comfortable wearing a scarf or something, especially in this hot weather.

[babu57]

Hello Sumeeth Shah Sir,

Much thanks for clearing all my doubts though of your busy schedules. My sincere apologies if my queries have disturbed any of your works. Finally the last question is can we give the nature products like Groviola fruit, kiwi fruit, wheat grain juice, greentea daily along with chemo treatment? or is there any risk of contradictory elements that disturbs the power of medicine or body functioning?

Thanks.

[manish_vkg TeamBCI]

Dear babu, as such there is no known interaction between fruits and chemo so u can give her any fruit..

Thanks

Manish

[MsLockYourPosts TeamBCI]

Babu - There are two U.S. based organizations which have very good patient information guides for Hodgkin's Lymphoma. The booklets can be read on line or downloaded for those outside of the U.S. When you get to the sites click on patient information or support, lymphoma, and then Hodgkin's Lymphoma.

You should also Google Neutropenic Diet. The Leukemia and Lymphoma Society link is a good one. If your wife is getting PEGEX I assume that her neutrophils are low which would make her more susceptible to infections. The Neutropenic Diet consists of well cooked foods, very careful food preparation, and avoiding any foods like yogurt or soft cheeses that have bacteria cultures. Ask her doctors about whether she should be following this diet.

The Leukemia and Lymphoma Society - lls.org

Lymphoma Research Foundation - lymphoma.org

The medications you mentioned have different names in the U.S.

Wysolone = prednisone

PEGEX = neupogen or neulasta Many find that the injections cause bone pain and that taking Claritin (loratadine) before and for a few days after the injections helps with the pain. Ask her doctor about it.

Ultracet = Tramadol and Tylenol

ABVD is the same here, so you will be able to read about it as treatment in the booklets.

I hope this helps. In addition to breast cancer, I deal with CLL which is a form of Non Hodgkin's Lymphoma and use these resources all of the time. If you have any trouble finding the information, please let me know.

Pat

[sumeet_shah Administrator in reply to MsLockYourPosts]

Very useful links and a useful explanation there, Pat. Thanks a lot

[babu57]

Sir my wife is also having teeth problem from so longer time. Maximum of her teeth were also lost, now the few which were left were getting loosened and because of which she is facing ache in tooths. In this stage where she is undergoing chemo for Hodgkin's disease, can we approach a dentist for her tooth extraction and artificial tooth placement? the dentist would give the local sedation while extraction and some antibiotics too would that now have any adverse affects Kindly advise sir.

Thanks,

[kontak TeamBCI in reply to babu57]

During chemo better to avoid

[MsLockYourPosts TeamBCI]

It is important to discuss this with her oncologist. Her immune system is probably affected by her chemotherapy. There is a risk that the dental procedures could cause infection which she would have trouble fighting, even if given an antibiotic for the procedure. It would be best to follow the oncologist's advice.

Pat