Diffuse large B-cell lymphoma (DLBCL): R-CHOP-14 or 21

Posted by fwpoole @fwpoole, Mon, Jul 22 5:56pm

With DLBCL, is there any benefit of doing R-CHOP therapy every 14 days VS 21 days, besides getting it I’ve with quicker? Information on web is spotty and inconclusive, at best yet, both cycles are approved. I’m a 64 year old male who was relatively good health before.

I believe in large part it depends on how quickly you can bounce back from your treatment. I had it sometimes every two weeks and sometimes every three weeks and once or twice at four weeks. This was all due to white cell count. I don’t think going every two versus three weeks has a huge outcome difference otherwise they would change the protocol. They can have a huge impact on you as an individual and quality-of-life however. I think this is an area where you have to develop a level of trust with your doctor. I would express your concerns and desires and listen carefully to his/her response.

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@fwpoole, I'd like to invite a few other members to share their, or their loved ones, experience with R-CHOP. @valerie912 and @ginpene05 both discussed going through R-CHOP and may be able to offer some additional insight on their experience with it along with @ckeys'. @fwpoole, if you are comfortable sharing, which regimen are you going to be started on, 14 or 21?

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@JustinMcClanahan

@fwpoole, I'd like to invite a few other members to share their, or their loved ones, experience with R-CHOP. @valerie912 and @ginpene05 both discussed going through R-CHOP and may be able to offer some additional insight on their experience with it along with @ckeys'. @fwpoole, if you are comfortable sharing, which regimen are you going to be started on, 14 or 21?

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Yes, I’m very comfortable sharing.

I’ve started on 21. I’m now 4 days post first cycle and am tolerating it pretty well, so far. So I’m considering speeding up the process.

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I did rchop last fall ending in February this year. I tolerated it fairly well, had 5 days of Zarxio shots after each treatment. The mouth sores were the worst part. I did a total of 6 treatments. The second being a half dose of rutuxin.

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How many treatments and did you need radiation?

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FWpoole, my first go around, I did 3 RCHOP, ever 3 weeks, followed by 21 radiation treatments. I’ve read in Cure magazine that chewing on ice chips during your chemo can help prevent mouth sores. I did the post treatment with L lysine and glutamate powder and my mouth sores were fairly tolerable. Talk to your doctor about magic mouthwash, too if you develop sores.

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@fwpoole

How many treatments and did you need radiation?

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I didn't have to do radiation for my cancer.

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Did you just do 3 cycles or more. I don’t need radiation either and have already finished 3 cycles, 3 weeks apart. My oncologist wants me to do one more but my tumor was completely removed so no radiation necessary. Personally I don’t see the need for more chemo.

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I did 6 cycles, that seems to be the standard. I showed no cancer after 3 cycles as well.

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@sbergerkinkade I’m so glad your treatment plan seems to have worked for you. In my research and experience, there is really no “standard” treatment plan for DLBCL that I’m aware of. There are many approaches I know about that indicate treatment is very individualized to the person’s specific diagnosis, desires, diseases, doctors’ recommendations and other potentially complicating factors like heart disease, age, and overall health. I invite others to comment if they have had a “standard treatment” and how it worked for them.

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I was diagnosed with stage 2. NCCN “guidelines” say 3 cycles + radiation or 6 cycles. As I stated, my tumor was removed so nothing to radiate. My scan just came back clean but oncologist wants one more cycle. I’m on the fence.

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@fwpoole

I was diagnosed with stage 2. NCCN “guidelines” say 3 cycles + radiation or 6 cycles. As I stated, my tumor was removed so nothing to radiate. My scan just came back clean but oncologist wants one more cycle. I’m on the fence.

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@fwpoole Whatever you decide will be the right choice for you!!! Some food for thought…

Since lymphoma is a circulatory disease, removing the tumorous node and tissue does not necessarily mean that there aren’t cells that could be cancerous nearby. Sometimes they have traveled to another lymph node already but have yet to grow enough to show evidence of disease. Sometimes it travels extra-nodal to other tissue, but again hasn’t grown enough yet.

Personally, having had to battle a particularly aggressive form of this disease, I would recommend a little more treatment in the beginning, versus additional treatment later. Mostly, I would encourage you to have a doctor who you can have open and comfortable communication with about your thoughts and concerns. That will help you trust their recommendations… Which should include some options to the number one suggestion that doc makes. It’s also important to know pros and cons of each option. Again, whatever you decide will be the right choice for you!!!

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Thanks @ckeys. I have opted for one more round of chemo torture which will be next week and be my LAST!

Interestingly, 20+ years ago I was subjected to a year of interferon and ribavirin self treatment for Hepatitis-C. I don’t remember that entire year being nearly as rough as the past 9 weeks of RCHOP.

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@ckeys

FWpoole, my first go around, I did 3 RCHOP, ever 3 weeks, followed by 21 radiation treatments. I’ve read in Cure magazine that chewing on ice chips during your chemo can help prevent mouth sores. I did the post treatment with L lysine and glutamate powder and my mouth sores were fairly tolerable. Talk to your doctor about magic mouthwash, too if you develop sores.

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@ckeys @sbergerkinkade – after 3 cycles, mouth sores have been very minimal. I keep a good oral hygiene regimen of flossing, brushing and tongue scraping followed by a Biotene rinse, which the oncology nurse recommended.

I know everyone is different but it’s working for me.

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That’s awesome…and good advice…it’s starts with oral hygiene!

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