RICE treatment onto Stem Cell Transplant

lindary
lindary Member Posts: 711 Member

Met with my oncologist today and the final word on my FNHL is that although the tumor had shrunk a lot after the first 4 R-CHOP treatments, there wasn't much shrinkage after the last two. So my options are to do Rituxan to try and keep the cancer held back. Radioimmunotherapy which I had not read up on at all. RICE followed by possible stem cell. I decided on the RICE with the hope it does what it needs to do so I will be eligible for Stem cell. For RICE I will be getting the drugs over 3 days in the hospital and then home untl the second cycle. After the 2 cycles there will be another scan. If all looks good I will be eligible for the Stem cell. All of this will be done at Rush in Chgo. I am not sure what to expect. 

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Comments

  • Rocquie
    Rocquie Member Posts: 858 Member
    lindary

    This disease of ours!

    I'm sorry to hear your doctors found that the R-CHOP had not done all that they (and you) had hoped. And so you are faced with additional treatment. RICE was discussed with me at one point, as well as stem cell transplant. My own lymphoma sneaked into remission but those options are not off the table for my future. 

    You are a very positive person and that will take you far as you move into another phase of treatment. You did very well with R-CHOP (with a bit of a bumpy start) and even continued to work. I have been very impressed and inspired by you. 

    I will look forward to hearing updates and will pray for you and your doctors.

    Big hugs,

    Rocquie

     

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,721 Member
    Good luck

    "RICE" of course is "ICE" plus "Rituxan."   One of the drugs is given in "hyperdosage". The combo is specifically for pre-SCT prep.  Doc told me a few years ago that if I relapse I would require ICE, so I read a little regarding it. (I have not relapsed, and have not required ICE myself.)

    I hope everything is successful for you,

    max

     

    http://chemocare.com/chemotherapy/acronyms/rice.aspx

     

    .

  • lindary
    lindary Member Posts: 711 Member
    Rocquie said:

    lindary

    This disease of ours!

    I'm sorry to hear your doctors found that the R-CHOP had not done all that they (and you) had hoped. And so you are faced with additional treatment. RICE was discussed with me at one point, as well as stem cell transplant. My own lymphoma sneaked into remission but those options are not off the table for my future. 

    You are a very positive person and that will take you far as you move into another phase of treatment. You did very well with R-CHOP (with a bit of a bumpy start) and even continued to work. I have been very impressed and inspired by you. 

    I will look forward to hearing updates and will pray for you and your doctors.

    Big hugs,

    Rocquie

     

    Thanks

    Thanks Rocquie. I heard from the dr office at Rush. Since my last scan was in June they want me to have one next week. They are going to schedule me next week, early in the morning to avoid heavy traffic. After the test we will wait for the results and then meet with the dr. I think they also said there will be someone from the clinic area there. I am expecting to hear more about the RICE treatment and we will schedule them. I will definitely have the first treatment within the next 2 weeks. Looking at the calendar and trying to see ahead, it looks like I will be doing the stem cell Oct-Nov. I am going to miss Halloween or Thanksgiving. My 2 favorite holidays. 

    I will admit that the last couple of days I haven't felt very positive. I think one reason is that all of this will be done at a hopsital that is not close and I don't know. Being there for 3 days for 2 cycles and then about a month for the stem cell, I can't see my husband making that drive a lot. With how bad traffic can be I don't want him doing that drive too often. We'll be doing a lot of talking on the phone. 

    Rush is a leading hospital in the country and the couple of times I have been there I have found that the people are great. Their oncology dept is supposed to be one of the best. It is also very big and easy to get lost in. I am sure all will go well and I will feel better as I learn more about what to expect. 

    Linda

  • lindary
    lindary Member Posts: 711 Member

    Good luck

    "RICE" of course is "ICE" plus "Rituxan."   One of the drugs is given in "hyperdosage". The combo is specifically for pre-SCT prep.  Doc told me a few years ago that if I relapse I would require ICE, so I read a little regarding it. (I have not relapsed, and have not required ICE myself.)

    I hope everything is successful for you,

    max

     

    http://chemocare.com/chemotherapy/acronyms/rice.aspx

     

    .

    SCT

    I've been doing a lot of reading on RICE and SCT. Now it's down to learning exactly how my treatments will be done. I kow I am doing the 3 day RICE. I have no idea if I will be able to go back to the office between treatments or have to stay home. All questions I hope to get answers on next week. Or at least some quidance. I have been told that I can bring my computers. (Yes that is plural.) I'm a geek and plan on connecting to work as well as me personal stuff. I will share my experience with all. 

  • Rocquie
    Rocquie Member Posts: 858 Member
    lindary said:

    Thanks

    Thanks Rocquie. I heard from the dr office at Rush. Since my last scan was in June they want me to have one next week. They are going to schedule me next week, early in the morning to avoid heavy traffic. After the test we will wait for the results and then meet with the dr. I think they also said there will be someone from the clinic area there. I am expecting to hear more about the RICE treatment and we will schedule them. I will definitely have the first treatment within the next 2 weeks. Looking at the calendar and trying to see ahead, it looks like I will be doing the stem cell Oct-Nov. I am going to miss Halloween or Thanksgiving. My 2 favorite holidays. 

    I will admit that the last couple of days I haven't felt very positive. I think one reason is that all of this will be done at a hopsital that is not close and I don't know. Being there for 3 days for 2 cycles and then about a month for the stem cell, I can't see my husband making that drive a lot. With how bad traffic can be I don't want him doing that drive too often. We'll be doing a lot of talking on the phone. 

    Rush is a leading hospital in the country and the couple of times I have been there I have found that the people are great. Their oncology dept is supposed to be one of the best. It is also very big and easy to get lost in. I am sure all will go well and I will feel better as I learn more about what to expect. 

    Linda

    SCT

    Hi Linda,

    The way it was explained to me, and the way Duke University Hospital handles Stem Cell Transplant:

    I could have the RICE at my local hospital. Then I would report to Duke, which is about a 4-hour drive from our home. They have affiliated apartments where patients stay for approximately 3 months, while reporting in to the clinic every day. Experience has shown that staying away from the hospital setting, as much as possible, reduces risks. I was told someone would have to be with me at all times. Our insurance would cover this.

    It turned out that I did not need to have the SCT at that time. And I'm sure all hospitals handle things differently. 

    I hope you get reassuring answers to all your questions soon.

    Blessings,

    Rocquie

     

  • lindary
    lindary Member Posts: 711 Member
    Rocquie said:

    SCT

    Hi Linda,

    The way it was explained to me, and the way Duke University Hospital handles Stem Cell Transplant:

    I could have the RICE at my local hospital. Then I would report to Duke, which is about a 4-hour drive from our home. They have affiliated apartments where patients stay for approximately 3 months, while reporting in to the clinic every day. Experience has shown that staying away from the hospital setting, as much as possible, reduces risks. I was told someone would have to be with me at all times. Our insurance would cover this.

    It turned out that I did not need to have the SCT at that time. And I'm sure all hospitals handle things differently. 

    I hope you get reassuring answers to all your questions soon.

    Blessings,

    Rocquie

     

    Treatment

    I would have had the Rice at our local hospital but my oncologist is on vacation most of this month. She felt since the stem cell would be done at Rush it would be a good idea for me to do teh RICE there so I get used to the staff and oncology area. Makes sense. It is about an hour drive from our house, two hours during rush hour. 

    I didn't hear from the hospital today so I gather they are having trouble scheduling me. I left a message and hope they will call me on Monday.

     

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,721 Member
    lindary said:

    SCT

    I've been doing a lot of reading on RICE and SCT. Now it's down to learning exactly how my treatments will be done. I kow I am doing the 3 day RICE. I have no idea if I will be able to go back to the office between treatments or have to stay home. All questions I hope to get answers on next week. Or at least some quidance. I have been told that I can bring my computers. (Yes that is plural.) I'm a geek and plan on connecting to work as well as me personal stuff. I will share my experience with all. 

    Rough Week

    Lindary,

    Our cancer center does SCT inpatient-only.  Hyperdose R-ICE (even without SCT) is usually inpatient, with neither going home or to work.  All commentators describe R-ICE as very, very harsh, usually much worse than ABVD. Hydration must be carefully monitored to avoid kidney damage, and WBC drugs (neulasta or similiar) are considered manditory.  It is not somethng that one can do on the run...

    Some events require that the workaday world be put on hold, even if only briefly.  Best of luck.  I am interested in what your protocol ends up being, since clinics do vary from place to place.

    max

  • lindary
    lindary Member Posts: 711 Member

    Rough Week

    Lindary,

    Our cancer center does SCT inpatient-only.  Hyperdose R-ICE (even without SCT) is usually inpatient, with neither going home or to work.  All commentators describe R-ICE as very, very harsh, usually much worse than ABVD. Hydration must be carefully monitored to avoid kidney damage, and WBC drugs (neulasta or similiar) are considered manditory.  It is not somethng that one can do on the run...

    Some events require that the workaday world be put on hold, even if only briefly.  Best of luck.  I am interested in what your protocol ends up being, since clinics do vary from place to place.

    max

    RICE - SCT

    Max,

    The RICE treatment is 2 cycles, 21 days each, with the actual treatment the first 3 days. Are you saying that I will have to be in the hospital the whole 21 days for the cycle? One place where I was reading up on RICE I got the impression that after the 3 days the paitient goes home. The WBC drugs is adminstered either in the office or at home. I had R-CHOP already with few problems. My biggest issue was the withdrawl after the 5 days of Prednisone. I worked 14 of the 15 days R-CHOP cycles. Graned, some days what I did was minimal and I got less day in a day than I usually did, but it took my mind off the treatments. My job allows me to work from home (or hospital). I am really hoping I get all the details this week. 

  • Rocquie
    Rocquie Member Posts: 858 Member
    lindary said:

    RICE - SCT

    Max,

    The RICE treatment is 2 cycles, 21 days each, with the actual treatment the first 3 days. Are you saying that I will have to be in the hospital the whole 21 days for the cycle? One place where I was reading up on RICE I got the impression that after the 3 days the paitient goes home. The WBC drugs is adminstered either in the office or at home. I had R-CHOP already with few problems. My biggest issue was the withdrawl after the 5 days of Prednisone. I worked 14 of the 15 days R-CHOP cycles. Graned, some days what I did was minimal and I got less day in a day than I usually did, but it took my mind off the treatments. My job allows me to work from home (or hospital). I am really hoping I get all the details this week. 

    RICE/SCT

    Hi Linda, I guess I wasn't very clear above with my reply. I was once considered a possible candidate for a stem cell transplant. I was referred to the Bone Marrow Clinic at Duke University which is about a 4 hour trip from our home. 

    I would receive RICE at our local hospital where I would be an inpatient for approximately 3 days for each treatment. 

    After the RICE treatments were done, I would go to Duke. As an inpatient, I would have the stem cells harvested and the transplant completed. After I was considered stable enough, I would be discharged to a private, nearby, affiliated apartment. For approximately 3 months, I would report into the clinic, every day, for labs and check up with my physician. 

    We live too far from the clinic for it to be feasible to live at home during this 3 months, thus the need for the temporary apartment. Our living expenses during this time would be covered by our insurance. 

    Because you are closer to your hospital, I don't know how it will be handled. But it will all be explained to you. 

    I believe you will be just fine. You have good doctors and you are going to a wonderful hospital. I'll be following your journey. . 

    Hugs,

    Rocquie

     

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,721 Member
    lindary said:

    RICE - SCT

    Max,

    The RICE treatment is 2 cycles, 21 days each, with the actual treatment the first 3 days. Are you saying that I will have to be in the hospital the whole 21 days for the cycle? One place where I was reading up on RICE I got the impression that after the 3 days the paitient goes home. The WBC drugs is adminstered either in the office or at home. I had R-CHOP already with few problems. My biggest issue was the withdrawl after the 5 days of Prednisone. I worked 14 of the 15 days R-CHOP cycles. Graned, some days what I did was minimal and I got less day in a day than I usually did, but it took my mind off the treatments. My job allows me to work from home (or hospital). I am really hoping I get all the details this week. 

    Rocquie

    Lindary,

    Rocquie gave an excellent answer that accords with all that I have read regarding R-ICE. 

    I suspect that after the three days of infusions you might be well enough to jaunt home if doing well, but that is pure speculation. Your oncologist or their lead RN/NP could surely answer these questions via a telephone call. 

    My neighbor with NHL did some kind of chemo similiar to R-ICE (but he never required SCT), with four days as an inpatient and then about two weeks home back-and-forth for six months, but he was never able to get out of bed, and was not seen outside except when his room-mate would carry him to the car to return to the hospital.  Continuous inpatient care would have surely been much easier and safer for him. 

    I hope RICE and your entire process is much easier, and also hope that safe returns home are OK for you. No two cases of even the same disease at the same stage and with the same drugs are ever identical here. Some patients are hospitalized for months on various drugs, and others are never hospitalized.

    max

  • lindary
    lindary Member Posts: 711 Member

    Rocquie

    Lindary,

    Rocquie gave an excellent answer that accords with all that I have read regarding R-ICE. 

    I suspect that after the three days of infusions you might be well enough to jaunt home if doing well, but that is pure speculation. Your oncologist or their lead RN/NP could surely answer these questions via a telephone call. 

    My neighbor with NHL did some kind of chemo similiar to R-ICE (but he never required SCT), with four days as an inpatient and then about two weeks home back-and-forth for six months, but he was never able to get out of bed, and was not seen outside except when his room-mate would carry him to the car to return to the hospital.  Continuous inpatient care would have surely been much easier and safer for him. 

    I hope RICE and your entire process is much easier, and also hope that safe returns home are OK for you. No two cases of even the same disease at the same stage and with the same drugs are ever identical here. Some patients are hospitalized for months on various drugs, and others are never hospitalized.

    max

    Merry-go-round

    It keeps getting more and more interesting. The nurse from my oncologist's office is back from vacation and called me. I told her what conversations had been had and all that. She informed me that Rush often has problems getting approval for Rituxan when the treatment (like R-CHOP) is started at another location because the insurance is reluctant to ok it being given at Rush. So she said what will be done is I will go to Rush for 3 days for ICE. Then day 4 at home and day 5 at my clinic getting the Rituxan. I am still waiting to hear back from Rush to find out when we have to go there to get things started. I just want to get things started.

     

    Linda

     

  • lindary
    lindary Member Posts: 711 Member
    lindary said:

    Merry-go-round

    It keeps getting more and more interesting. The nurse from my oncologist's office is back from vacation and called me. I told her what conversations had been had and all that. She informed me that Rush often has problems getting approval for Rituxan when the treatment (like R-CHOP) is started at another location because the insurance is reluctant to ok it being given at Rush. So she said what will be done is I will go to Rush for 3 days for ICE. Then day 4 at home and day 5 at my clinic getting the Rituxan. I am still waiting to hear back from Rush to find out when we have to go there to get things started. I just want to get things started.

     

    Linda

     

    CT scan done

    After some mis-communications I finally got the appts for today at Rush. The blood draw, dr and last the CT scan. The dr's assistant when over the major points of the blood test. Number look good and osme are better than they would expect for someone who had dones 6 cycles of R-Chop. I will get a call tomorrow with the results of the CT scan and then schedule the ICE treatment. I'm looking at maybe starting it on Thur. Then I can have my clinc schedule the Rituxan on Monday. Let's see if this goes smoother than trying to arrange the tests. 

  • Rocquie
    Rocquie Member Posts: 858 Member
    lindary said:

    CT scan done

    After some mis-communications I finally got the appts for today at Rush. The blood draw, dr and last the CT scan. The dr's assistant when over the major points of the blood test. Number look good and osme are better than they would expect for someone who had dones 6 cycles of R-Chop. I will get a call tomorrow with the results of the CT scan and then schedule the ICE treatment. I'm looking at maybe starting it on Thur. Then I can have my clinc schedule the Rituxan on Monday. Let's see if this goes smoother than trying to arrange the tests. 

    Merry-Go-Round

    Linda, they really do have you on a merry-go-round! I hope things smooth out for you before you begin treatment.

    Hugs,

    Rocquie

  • lindary
    lindary Member Posts: 711 Member
    Rocquie said:

    Merry-Go-Round

    Linda, they really do have you on a merry-go-round! I hope things smooth out for you before you begin treatment.

    Hugs,

    Rocquie

    getting better

    Things did go better today. The medical assistant to the dr at Rush called me to go over the CT scan results. Tumor has grown a bit since June but that is not surprising since I have not had any chemo or Rituxan since June. The plan is for me to start the ICE chemo on Thur, if there is a bed available. I will be notified Wed after 5 pm on that. This way I'll be home on Sunday and at my oncolgist office for the Rituxan and Nurlasta on Monday. Before I head home I iwll also know how often I have to get a blood test done. As goofy ans things may be I keep reminding myself that this is only 2 cycles. Then another CT scan (probably at Rush) to see what progress was made and if Stem Cell is next. At least I feel like there is a plan in place. 

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,721 Member
    lindary said:

    getting better

    Things did go better today. The medical assistant to the dr at Rush called me to go over the CT scan results. Tumor has grown a bit since June but that is not surprising since I have not had any chemo or Rituxan since June. The plan is for me to start the ICE chemo on Thur, if there is a bed available. I will be notified Wed after 5 pm on that. This way I'll be home on Sunday and at my oncolgist office for the Rituxan and Nurlasta on Monday. Before I head home I iwll also know how often I have to get a blood test done. As goofy ans things may be I keep reminding myself that this is only 2 cycles. Then another CT scan (probably at Rush) to see what progress was made and if Stem Cell is next. At least I feel like there is a plan in place. 

    Good luck

    Lin,

    Yes, there is relief in having a plan in place and a schedule that a patient can orient themself around.  You know that everyone here is checking daily on you and pulling for you to get through this easily and successfully,

    max

  • lindary
    lindary Member Posts: 711 Member

    Good luck

    Lin,

    Yes, there is relief in having a plan in place and a schedule that a patient can orient themself around.  You know that everyone here is checking daily on you and pulling for you to get through this easily and successfully,

    max

    ICE

    Everything is coming together. I was told I would hear from the hospital after 5 pm and the called about 6:30pm, about 20 mins after I got home from work. I need to be there about 8 am so I am getting my stuff together. Since I will be there 3 days I am bringing both latops with (work and personal). Our youngest lives in the city and is going to visit me on Saturday. Now that things are rolling I am feeling more comfortable about everything.

  • lindary
    lindary Member Posts: 711 Member
    lindary said:

    ICE

    Everything is coming together. I was told I would hear from the hospital after 5 pm and the called about 6:30pm, about 20 mins after I got home from work. I need to be there about 8 am so I am getting my stuff together. Since I will be there 3 days I am bringing both latops with (work and personal). Our youngest lives in the city and is going to visit me on Saturday. Now that things are rolling I am feeling more comfortable about everything.

    Day 1

    Today has gone well. Got the first day of the treatment. Tomorrow is when I start the drugs that takes 24 hrs. 

     

     

  • lindary
    lindary Member Posts: 711 Member
    lindary said:

    Day 1

    Today has gone well. Got the first day of the treatment. Tomorrow is when I start the drugs that takes 24 hrs. 

     

     

    First round done

    Just finished my first round of iCE. I go home tomorrow and then on Monday go to my oncologist for the Rituxan and Neulasta.

    Only issues during the ICE was when I was getting the Ifosfamide the pump kept beeping every 90 - 120 mins for "air in pump" They said this is because the drug is fizzy. Usually it was right around the time I was going to go to the bathroom to pee. But it did leave me tired. 

    Other good news is that my son & daughter-in-law are at the hopspital having a baby. This is #4!!

     

     

  • Rocquie
    Rocquie Member Posts: 858 Member
    lindary said:

    First round done

    Just finished my first round of iCE. I go home tomorrow and then on Monday go to my oncologist for the Rituxan and Neulasta.

    Only issues during the ICE was when I was getting the Ifosfamide the pump kept beeping every 90 - 120 mins for "air in pump" They said this is because the drug is fizzy. Usually it was right around the time I was going to go to the bathroom to pee. But it did leave me tired. 

    Other good news is that my son & daughter-in-law are at the hopspital having a baby. This is #4!!

     

     

    Linda, you are amazing! You made it through your first ICE treatment and the most negative thing about it was a beeping pump. Bless you. I hope you stay in your PJ's and rest all day before going for your Rituxan Monday. 

    Thank you for the update. I have been thinking of you all weekend. And I suppose #4 has been born by now? Smile

    Blessings,

    Rocquie

     

  • lindary
    lindary Member Posts: 711 Member
    Rocquie said:

    Linda, you are amazing! You made it through your first ICE treatment and the most negative thing about it was a beeping pump. Bless you. I hope you stay in your PJ's and rest all day before going for your Rituxan Monday. 

    Thank you for the update. I have been thinking of you all weekend. And I suppose #4 has been born by now? Smile

    Blessings,

    Rocquie

     

    Today

    Actually I got dressed today. It is my way of telling myself life goes on and I have things to do. Plus it was a nice day too. 

    My newest grand daughter was born last night at 8:40 pm. She is 8 lbs 3 oz and 21 inches long. Little bigger than their first 3. The neat thing that my one daughter got the to pick up the other 3 from the hospital. Just as they were about to leave the nurse came out and told them that if they stuck around for a bit they would get to see the baby. It was about 30 mins but then Haley was born. Her brother & sisters got to see her before their sleepover at the auntie's place. They sent out some great pictures. 

    I can't visit with them right now but we did skype so I could see mom & the baby. My daughter-in-law is doing good. They are both spending a second night at the hopsital. Main reason is mom had Group B strep and they need to keep the baby there 24 hours. So mom is taking a break from the other 3 for another night. Dad will have them tonight. 

    I have Rituxan tomorrow. Also need to do an online meeting for work. Will be interesting since I've never done one during chemo. Right now I am tired from the last 3 days. Peeing a LOT with all of the fluids pumped through me plus the chemo brain, mainly in the evening. One thing I know for sure, I am going to bed early. I think it all went well. 

     

    LindaSmile