Cancer Survivors Network - Comments for "R-Epoch treatment" Comments for "R-Epoch treatment" en-csn Thread <p>Thanks, Max.</p> <p>I can do that. My main intent was to offer advice to others on the thread, including Tony.</p> Mon, 26 Nov 2012 18:20:51 +0000 JP_NHL comment 1308619 at Thread <p>JP,</p> <p>I would create a new thread for this question.</p> <p>It is very eassy to do so. Buried in this older thread, people who can assist are less likely to see it.</p> <p>max</p> Sat, 24 Nov 2012 23:43:06 +0000 Max Former Hodgkins Stage 3 comment 1308036 at Dose-adjusted EPOCH treatment <p>I was diagnosed with diffuse large B-cell Non-Hodgkin's Lymphoma in July 2012. I have a rare aggressive sub-class referred to as a "double-hit" translocation: there are two mutations going on concurrently. Consequently, the malignant tumor was doubling in area every two weeks. </p> <p>I started treatment in August 2012. My regimen consists of Rituxan on Day 0 then a 24-hour cocktail of Etoposide, Vincristine and Doxorubicin for four consecutive days. On Day 5, I receive a smaller bag of a carcinogen called Cyclophosphamide. There are several drugs I take, mostly anti-fungal, anti-viral and antibacterial. I also take Prednisone, a strong steroid considered part of EPOCH regimen.</p> <p>Last week I finished the 5th cycle. I had gone through my first three cycles without hitting the "nadir" (becoming neutropenic). Dose-adjusted EPOCH is flexible in that the dosage changes based on how the patient responds to treatment. Since I didn't hit the nadir, my high dosage was increased by 20% in rounds 2, 3 and 4. By cycle 4, my dosage was 75% higher than in round 1. Because the dosages were increasing, another drug, Mesna, was added to Day 5. Mesna counteracts the corrosive effects cyclophosphamide has on the bladder and kidneys. After cycle 4, I became neutropenic and had a nasty case of oral mucositis. Given the setback in round 4, my dosage for cycle 5 was reduced by 10%. </p> <p>I have a big decision to make in the next week or so: Do I complete the 8 cycles of EPOCH and call it a day, or do I stop at 6 cycles and move forward with the stem cell transplant. My biggest concern is the long-term effect of high dosage chemo, which increases with the stem cell transplant. For example, exposure to high-dosage chemo increases the risk of myelodysplastic syndrome (MDS). This is when the bone marrow no longer produces healthy red and white blood cells.</p> <p>Aside from NHL, I am a healthy and active male. I would jog frequently and do other exercises to keep me in shape. I cannot jog now (for risk of passing out), but I do walk a mile or so if it's a nice day and I'm feeling up to it. I also do modified exercises at home with dumbbells. I have a double-lumen PICC line in my right arm; it doesn't dissuade me from using it to do some basic lifting or isometrics (don't go overboard). The key is to stay active--physically, mentally, spiritually--esp. in between treatment. There are going to be your share of bad days, where all you can do is stay in bed and rest. That's fine. Like everything in life; it's a balance. Find the balance that works for you and stay positive!</p> <p>JP</p> Wed, 21 Nov 2012 17:27:14 +0000 JP_NHL comment 1307154 at Just completed by 3rd round <p>Just completed by 3rd round of epoch r and have what I would call acute shortness of breath. Getting up from a chair to go to the front door or taking a shower requires me to sit down as if I had run around the block at full speed. Very bothersome.<br /> I get cytoxan on the Friday of the cycle and that stuff just puts me under for three days.<br /> My doc doesnt appear to be as familiar with epoch as the other regimens I've had but this shortness of breath issue looks like its going to get worse with each treatment.<br /> Any other experiences appreciated.<br /> Tony</p> Wed, 21 Nov 2012 11:19:08 +0000 trcox57 comment 1307063 at Judgement <p>KMN,</p> <p>Oncologists and drug companies use a blurb regarding their decision to use treatment, verses not using it, to avoid side-effects. It goes something like </p> <p>"Your doctor has decided that the potential beneficial effects of drug xxx outweight the potential negative effects of its administration."</p> <p>In other words, the good it should do outweighs the potential bad it might do, in their professional judgement. It might be the case that, despite his weakness and medical problems, they felt that some cancer killing regimne HAD to get started, despite increased risks. That sounds like the case. These docs are squeezed and have to make difficult judgement calls every day.</p> <p>Your ordeal was horrible, and I can relate, based upon some of my own experiences with side-effects, and side-effects suffered by others.</p> <p>The easiest way to find out, I guess, would be to schedule an appointment with the doctor, and ask him directly.</p> <p>max</p> Sun, 04 Nov 2012 22:12:51 +0000 Max Former Hodgkins Stage 3 comment 1301316 at Drug/Lung <p>Bobnkay,</p> <p>I do not know if bleomycin is part of EPOCH, but it is the "B" drug in abvd, which I did 12 infusions of.</p> <p>It causes lung toxicity in around 10% of all users, and it really messed me up. I still have shortness of breath fairly severely almost three years later, and have a constant cough. </p> <p>Ask his doc if anything he is receiving is chemically similiar to bleomycin. Several chemo drugs do cause lung toxicity and forms of oxygen poisoning in some patients.</p> <p>max</p> Sun, 04 Nov 2012 22:05:07 +0000 Max Former Hodgkins Stage 3 comment 1301314 at I'm in my second cycle of <p>I'm in my second cycle of epoch r for B cell follicular NHL. Previously did rcvp and Rituxan and bendamustine but relapsed after both courses with 3 months. Diagnosed in June 2009.<br /> Epoch r is distinctly harder to tolerate after round 2. Numbness in my fingers feet and loss of taste and sore mouth when my WBC crashes.<br /> My most bothersome side effect is getting winded getting off the couch and walking to the front door. I didn't have any of that with previous rounds. Also my resting heart rate stays about 110 for some reason. Got everything checked to make sure it's not some thing with cardio toxicity due to the adreomyacin or etopiside.<br /> I'm told the side effects will likely escalate but to what degree depends .......<br /> I'll try to report my experience and grateful for any info from those with similar circumstances.<br /> TonyC</p> Sun, 04 Nov 2012 18:52:14 +0000 trcox57 comment 1301250 at Heartburn <p>Dixie,</p> <p>I have had severe, severe reflux for years (not cancer related). Nexium is great, but requires pescription. Nexium by itself no longer works for me, however. I take one or two generic Ranitidine (over the counter) pills a day, and have no problems. </p> <p>Ranitidine is the active ingredient in Zantac. Tums or Rollaids do me no good at all.</p> <p>Pepsid does not work for me either. Zantac is much better.</p> <p>max</p> Wed, 26 Sep 2012 22:16:39 +0000 Max Former Hodgkins Stage 3 comment 1285650 at R EPOCH <p>Just completed the third round of R EPOCH for DLBCL. Responding well but managing side effects has been challenging. Still have some hair. Developed AFIB after second round. Scheduled for a PET Scan at the start of the fourth round. Hopefull for a good PET scan result in two weeks.</p> Tue, 25 Sep 2012 21:32:46 +0000 Papajohn1950 comment 1285216 at Jack, I am so very sorry <p>Jack,</p> <p>I am so very sorry that you and your family suffered such a horrible tragedy. It is heart breaking. </p> <p>It's so difficult to speculate as to what happened and why, without actually having been there. Even then, you may still not get the complete story due to the stress and anxiety of the situation. I can only imagine that the doctors thought that the treatment benefit out weighed the potential side effects. Could he have been on a trial of some sort? The destruction of the cancer cells which is one of the reasons chemo works, ( lysing), can actually cause renal failure. </p> <p>I pray that your family can heal and find some peace,<br /> Kellie</p> Wed, 01 Jun 2011 19:07:26 +0000 KC13167 comment 1066365 at