When I was first treated for cancer in 1981, there was no such thing as a CT scan. There was no such thing as a PET (Positronic Emissions Test.) If the doctors wanted to see inside of you, they cut you open and looked inside. This was called a "staging laparotomy." If they wanted to see what was happening inside of an organ, they made a biopsy of the organ. If the organ was one that would bleed, the doctors took the organ. Radiation therapy was broad field radiation, irradiating large sections of the body. There was no anti-nausea medicine. Bone marrow tests were taken through surgery by chipping a hip or the sternum. To my knowledge, treatment consisted of chemotherapy, radiation therapy and surgery.
In 1981, as a 14 year old, I spent three weeks in the hospital after a staging laparotomy. The first three days after, I was semi-conscious and in pain. In my momentary lapses into consciousness, I refused pain medication. Literally, I was half out of my head. My blood pressure was 200/??. I am grateful that my mother respected my half conscious, ramblings. She tried to convince me to take pain meds during the moments in which I was awake, but she didn't make the decision for me. I had to do so, myself. Incidentally, I recommend the pain meds. When, eventually, I accepted them, I rested easier and my blood pressure returned to its normal 115/60.
When I was first treated, they conducted a test called a lymphangiogram. This is where they cut your feet, insert small needles into them and use a pump that looks like a little sewing machine to pump dye into your lymph system. This dye "lights up" the lymph system so that it will appear on x-rays. They don't do this test anymore.
Because there was no anti-nausea medicine, during chemotherapy, you bore the entire brunt of the medicines. Adreamycin was the worst for me. It was a high volume of red chemical. It was always refrigerated. It was pushed through the vein. Because it was cold, I always felt it enter my arm and move to the heart. Because it carries no oxygen, you feel it enter the heart and pump through. It gives a bad taste in the mouth and makes the bile rise in the stomach. To this day, I can't chew double mint gum, because that is what I used to veil the bad taste in the mouth. The anti-nausea medicines available today make taking chemotherapy much easier. An unfortunate side effect is that they also shut down your digestive system, which is uncomfortable.
Previously, to diagnose the particular kind of cancer that you had, the doctors would remove a tumor and conduct a biopsy. They still do that today.
If they want to stage you now, they will conduct a CT scan. You will not be able to eat before the test. You will drink barium prior to the CT scan and wait for it to infiltrate your system. You will probably not see a doctor. Rather a technician will put an IV into a vein. You will feel the injection. It is a cold liquid that also does not carry oxygen. It goes straight to your heart. You feel it get there. But, the sensation of illness is very short (and believe me is much better than a staging laporatomy.) In my experience, the table moves you back and forth as you lay on it. You are moved in and out of a big metal donut. The guts of the metallic donut spin around you. The technician may give you commands or commands may come in the form of a prerecorded message. Either way, the test does not generally last very long.
A PET/CT is very similar to a regular CT except that you have to avoid sugars and exercise the day before the test. This is because a PET/CT determines if there are parts of your body that are metabolizing sugars. If you exercise, the test will have an inaccurate measurement. If the doctors see an area that is metabolizing sugars too quickly, they will call it a "hot spot." That will indicate the existence of active cancer cells.
In addition to treatment with chemotherapy, certain antibody therapies (called immuno therapies) are now available. In my case, the doctor treats me with Rotuxomab. This is an antibody treatment that attacks CD-20 cells. This treatment only works with cancers that are CD-20 rich, such as Nodular Lymphocyte Predominant HD.
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There are 4 classical and one non-classical forms
of HD. They are as follows:
of HD. They are as follows:
- Nodular sclerosis(NS)
NS accounts for 60-70% of Hodgkin's cases. - Lymphocyte predominance (LP).
LP accounts for 5% of Hodgkin's cases. - Mixed Cellularity (MC)
MC accounts for 20-30% of Hodgkin's cases. - Lymphocyte depleted (LD)
LD accounts for about 5% of Hodgkin's cases.
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