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Radiation, Blood Counts, and R-CHOP

Simon24
Posts: 45
Joined: Oct 2015

I am curious about radiation after R-CHOP.  My husband has finished four out of six rounds of R-CHOP and has received two out of four preventative Intrathecal treatments.  His WBC is very low (0.5) and will be having his PET scan in a few days to see if the chemo has been effective.  The fatigue is much greater after round four than it was in the earlier sessions.  He will have radiation after the six sessions of R-CHOP.  Does radiation cause low blood counts and fatigue the way chemo does? Right now he is on antibiotics because of the low blood count.  I guess this is not unusual, but I am concerned about what we can expect with regard to radiation. We have not talked with the radiology oncologist yet.    Simone

Simon24
Posts: 45
Joined: Oct 2015

I forgot to say that he has Diffuse Large B Cell NHL.     Simone

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3522
Joined: May 2012

Simon,

 

Is your husband on neulasta ? It is given to most people on chop or abvd to increase WBC production. (Technically it is referred to as a 'colony booster').   I don't know why it wouldn't work as well against radiation depletion as chemo depletion of WBCs.   Ask his oncologist a about it.

Simon24
Posts: 45
Joined: Oct 2015

Hi Max,

    He receives a neulasta shot 24 hours after R-CHOP.  Right now his WBC count is very low and he is exhausted.  He wasn't like this after the first three treatments and I understand it does get worse as treatments progress.  He is also getting the intrathecal chemo in between R-CHOP chemos which may make the situation worse.  He also gets spinal tap headaches so it hasn't been easy to have too many days that are semi normal.  I guess I shouldn't be worrying about radiation before it happens, but I tend to think ahead.  I will ask the radiation oncologist about the neulasta when we meet him/her.  Thank you for your suggestion.  I really appreciate the advice.                    Simone

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3522
Joined: May 2012

I know the chemo directed into the chest cavity is supposed to be quite tough.  He is in a real fight.  I never had therapeudic radiation, so cannot comment, but just guessing, I would think it might affect his WBC less than chop, but this is just a guess.

We are pulling for you two.  I hope you share what the radiation oncologist says, since his treatment combination is fairly rare. Not unheard of here over the years, but certainly not the norm.

 

I pray a good weekend for you,

max

Simon24
Posts: 45
Joined: Oct 2015

Intrathecal chemo is adminstered into the spine somewhat like a spinal tap and a small amount of spinal fluid is taken out to check to see if there are any cancer cells.  The pre-chemo spinal tap took quite a bit of fluid out and my husband had a severe eight day spinal headache. The intrathecal chemo is not as bad because a smaller amount of fluid is removed, but he still gets headaches from it.  He stays on his back for several hours after the procedure and then does the same when he gets home.  Sitting and standing up too soon after the procedure brings on headaches.  Not everyone gets spinal headaches, but he does.  Intrathecal chemo is a precautionary procedure which we hope will be worth it. 

Thank you for your good wishes.  We hope you will have a nice weekend, too.

forme's picture
forme
Posts: 1162
Joined: Aug 2010

Hello Simone,

 

I have not posted much lately, but try to follow along.

 

Radiation is more likely to deplete or have an effect on bone marrow and red blood cells. So don't be surprised if the docs mention a red blood cell booster instead od white blood cells.

Positive thoughs and best to to you and your husband

 

Simon24
Posts: 45
Joined: Oct 2015

At this point his red blood cells are still not in the normal range, but are starting to rebound so I will definitely ask if he can have a red blood cell booster if needed with his radiation.  I know chemo can do a number on blood counts, but it is somewhat scary.  To top it off, he went outside for no more than five minutes today and had a deer tick crawling on him.  When he was first diagnosed with cancer this summer he also tested positive for Lymes disease for the second time and needed to have antibiotics for a month.  Both times he's had Lymes he found an embedded tick and became sick within a day or two afterwards. The first time he had the classic bulls eye rash and the second time his arm became swollen where the tick embedded.  His reaction to Lymes disease is somewhat similar to chemo fatigue. Needless to say, I am very nervous when I see deer ticks. They are so small and tough to spot.  Thankfully, the little critter today didn't have a chance to embed and is now history. 

Thanks again for sharing your information.  We appreciate it.                         Simone

illead's picture
illead
Posts: 863
Joined: Aug 2012

Sounds like you need a long, strong one.  My thoughts are with you, I know what it is like to be the caregiver.  Hoping things go in a positive direction, they usually do with lymphoma, the symptoms and start of treatment usually end up as a bad dream with a positive outlook ahead.

Becky

Simon24
Posts: 45
Joined: Oct 2015

Thank you for the positive thoughts, Becky.  We've tried to maintain a positive attitude since this all started this summer, but for some reason the tick really made me mad. It was like the straw that broke the camels back.  Anyway, after a few days of resting my husband seems to be feeling a little better. Best wishes to you both for a nice Sunday.             Simone

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