Staging and Treatment Plan

I saw my Oncologist for the first time today.  I am being treated by Dr. Diego Villa Restrepo at the BCCA.  Yeah, his name is Restrepo.  Go see the movie.  It's good. 

The CT results of my abdomen and pelvis showed involvement below the diaphragm so I have been officially staged as IIIb.

CT Abdomen and Pelvis Report

History

Work up Lymphoma

Technique

Contrast enhanced images were obtained through the abdomen and pelvis.

Findings

There is a moderate-sized pericardial effusion identified measuring up to 1.6cm in thickness.  There are enlarged lymph nodes up to 15mm short axis anterior to the esophagus near the abdomen hiatus. Enlarged lymph nodes are also present in the gastrohepatic ligament and cellac axis region measuring up to 2.1cm short axis.  Enlarged paracaval lymph nodes are seen from the level of the SMA distally.  These measure up to 18mm. From the level of the aortic bifurcation distally there are small lymph nodes present but none are markedly enlarged. A right lliac chain lymph node measures 10mm short axis.  The spleen measures up to 15.9cm and contains three round low-attenuation lesions measuring up to 14mm.  These do not appear cystic.  No focal hepatic lesions are seen and the gallbladder, adrenals and pancreas are within normal limits.  No focal renal abnormalities are seen.  There is a trace of free fluid in the pelvis.  The appendix is unremarkable.

Impression

Pericardial effusion. Splenomegaly with associated focal splenic lesions which can be seen in lymphoma.  Mild intra-abdominal and pelvic lymphadenopathy which is more prominent in the epigastric region.

Treatment will be 6 cycles of ABVD chemotherapy.  Each cycle of ABVD is 28 days with an infusion on the 1^st and 15^th day.  Post chemo I will receive a CT and possibly PET scan to determine whether or not radiation will be necessary.   I will post more details about ABVD later this week.

Pre-chemo I will have an echocardiogram to get a baseline heart function to compare against during treatment should heart issues arise.  The A drug in ABVD, Adriamycin, can be cardiotoxic, which means it can be toxic to the heart. 

I have been prescribed Prednisone (100mg every morning for 7 days) and Cyclophosphamide (100mg every morning for 7 days) to ease the inflammation and increase comfort while waiting for chemo to start. 

ABVD will likely begin on March 29^th.