The eve of treatment
Nearly two months ago was my 'diagnosis day' and tomorrow I'm finally beginning chemotherapy. What's the hold-up here? Well, two things.
First of all, the national cancer center here doesn't treat lymphoma so I needed to move to a new hospital and repeat a lot of things. There are several hospitals in Amsterdam and all of them have hematology departments. In order to improve specialization and reduce redundancy, the cancer center dropped hematology so with my lymphoma diagnosis, I had to go elsewhere for treatment. This meant I needed a new team of specialists reviewing my case and fine tuning the diagnosis and had to repeat several meetings to prepare me for the Hogdkin's treatment that I previously had with a range of specialists to prepare for the treatment for nasopharyngeal carcinoma.
Seeing hematologists instead of ENTs was a breath of fresh air. Suddenly all my 'peculiar' symptoms, namely the pain in my lymph nodes from alcohol, were recognized by a professional and it all clicked. Apparently blood cancers are an 'exotic' field so most other doctors aren't aware of this symptom.
With the information and biopsy from the cancer institute, they came to the diagnosis of classic Hodgkin's, stage IIA favorable. The cancer is only localized in several areas in the upper half of my body; I don't have any B symptoms (weight loss, night sweats, fatigue); and no risk factors like bulky tumors. Essentially, my prognosis is extremely good, >95% survival rate and treatments are constantly improving. This allows us to keep the focus of treatment on minimizing long-term effects. Which brings us to the second reason for the time between diagnosis and treatment.
Second of all, I underwent two cycles of egg freezing. The baseline treatment poses a low risk to my fertility, but there's always the chance that we need to escalate to a more intense chemotherapy regime in which case fertility issues may become a real issue. That's been a whole other adventure itself - even at a third hospital. For two 2-3 week cycles, I've been injecting two syringes of hormones into my belly and receiving ultrasounds every few days and periodic bloodwork for monitoring. The egg retrieval procedure is also an interesting one. Under light general sedation (morphine injection) and some local anesthesia, the doctors use a fine needle guided by ultrasound to gather the egg cells from my ovaries. Also not a comfortable procedure but, eh, manageable. Especially since Dane was allowed to join for the entire operation :-)
I've been grateful to have the flexibility and stability to allow time for the fertility treatment. While the more egg cells we freeze the better, we're also running the risk of the lymphoma developing into a less favorable condition, increasing the risks associated with treatment. So now it's the time to move forward. Tomorrow's the day!
First of all, the national cancer center here doesn't treat lymphoma so I needed to move to a new hospital and repeat a lot of things. There are several hospitals in Amsterdam and all of them have hematology departments. In order to improve specialization and reduce redundancy, the cancer center dropped hematology so with my lymphoma diagnosis, I had to go elsewhere for treatment. This meant I needed a new team of specialists reviewing my case and fine tuning the diagnosis and had to repeat several meetings to prepare me for the Hogdkin's treatment that I previously had with a range of specialists to prepare for the treatment for nasopharyngeal carcinoma.
Seeing hematologists instead of ENTs was a breath of fresh air. Suddenly all my 'peculiar' symptoms, namely the pain in my lymph nodes from alcohol, were recognized by a professional and it all clicked. Apparently blood cancers are an 'exotic' field so most other doctors aren't aware of this symptom.
With the information and biopsy from the cancer institute, they came to the diagnosis of classic Hodgkin's, stage IIA favorable. The cancer is only localized in several areas in the upper half of my body; I don't have any B symptoms (weight loss, night sweats, fatigue); and no risk factors like bulky tumors. Essentially, my prognosis is extremely good, >95% survival rate and treatments are constantly improving. This allows us to keep the focus of treatment on minimizing long-term effects. Which brings us to the second reason for the time between diagnosis and treatment.
Second of all, I underwent two cycles of egg freezing. The baseline treatment poses a low risk to my fertility, but there's always the chance that we need to escalate to a more intense chemotherapy regime in which case fertility issues may become a real issue. That's been a whole other adventure itself - even at a third hospital. For two 2-3 week cycles, I've been injecting two syringes of hormones into my belly and receiving ultrasounds every few days and periodic bloodwork for monitoring. The egg retrieval procedure is also an interesting one. Under light general sedation (morphine injection) and some local anesthesia, the doctors use a fine needle guided by ultrasound to gather the egg cells from my ovaries. Also not a comfortable procedure but, eh, manageable. Especially since Dane was allowed to join for the entire operation :-)
I've been grateful to have the flexibility and stability to allow time for the fertility treatment. While the more egg cells we freeze the better, we're also running the risk of the lymphoma developing into a less favorable condition, increasing the risks associated with treatment. So now it's the time to move forward. Tomorrow's the day!
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