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CHOP-R therapy

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Old 10-23-2008, 09:14 PM   #1
Join Date: Sep 2008
Location: Jefferson, LA
Posts: 7
lynne50 HB User
CHOP-R therapy

My dad has just begun CHOP-R chemotherapy for follicular lymphoma (B cell). He was diagnosed a year ago, and other chemo treatments haven't been effective. He retains fluid in his belly and eventually the swelling affects his feet. He has no other significant symptoms of the lymphoma, except that he retains so much fluid, and then has to have his abdoment drained with a needle. He was given the CHOP through a picc line in the hospital for 48 continuous hours. (usually its 24 hours, but he is in his 80's) Has anyone had CHOP-R (with rituxan) treatments with good results?
And what kind of side effects can we expect?

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Old 11-13-2008, 09:48 AM   #2
Join Date: May 2008
Location: nowheresville, PA, USA
Posts: 118
ntbd HB User
Re: CHOP-R therapy

the prednisone can cause edema. Cut way back on salt. The prednisone can lead to diabetes like conditions. Cut back on high GI foods (which is complicated).

The Adriamycin (hydroxydoxorubicin) aka red devil can damage the heart. Take melatonin and CoQ10. He should be getting Doxil instead of the Adria anyway at his age (and probably is), but still take melatonin and CoQ10.

Last edited by ntbd; 11-13-2008 at 10:17 AM.

Old 11-14-2008, 06:09 AM   #3
Join Date: Sep 2008
Location: Jefferson, LA
Posts: 7
lynne50 HB User
Re: CHOP-R therapy

Thanks ntbd for reply. What is doxil?

Before he received adria they did heart tests and said he had a strong heart. He is 87 and has a good mind. I take it that melatonin and CoQ10 are supplements we can get at drug store?
He is in hospital now receiving rituxan and his 2nd round of adria (looks like koolaid); after his first treatment 3 weeks ago, he had NO side effects. Doctor did a cat scan and said the nodes got smaller, even though his belly got big and had fluid in/around his lungs, which caused him to wheeze. They did a paracentecis and thoracentecis. Between the two, they drained 3 1/2 liters of fluid. They give the chemo over 48 hrs. instead of 24 because of his age. Any other specifics would be appreciated.

Old 11-14-2008, 07:07 AM   #4
Join Date: Feb 2006
Location: ohio
Posts: 96
SallyD HB User
Re: CHOP-R therapy

HI! My dad is 76, and completed his last r-chop treatment last Feb. He is doing wonderfully.
R-chop is very harsh. It is also accumlative, meaning symptoms worsen over the course of tratment.
Dad had large b cell.

Last winter was a rough one, but he is now trying to get his strength back, takes senior aerobics, and walks several miles a day. He is even heading to florida for the winter this year. and his last pet scan showed no cancer.

Dad was able to tolerate the R-chop fairly well, and was able to have his done in one day.

The only major problems we had with dad were that he had trouble keeping his white blood cells up, he had mouth and anus sores, and migraines toward the end.

There were a lot of other complaints, but those were the biggest.

Lymphoma is not a death sentence. But I will tell you that things will get worse before they get better. My Dad was so sick at one point we were all ready to give up. But he kept on fighting, and we bought him some more time with us.

The biggest thing you need to watch for is: any fevers..(keep him away from any people or places where he can contact germs) My dad became a

Soft food helps couldn't tolerate meat, or anything he had to chew alot. stool softeners, help with the anus sores.

feed him lots of good food...real butter, keep the fat in...don't do the health food, diets..he needs lots of calories. Dad still has not gained back the 40 lbs he lost. (and they will possibly postpone his teatments if he loses too much weight.)

I'm not on here everyday, (trying to put this behind us) but I still pop in from time to time. If you have any questions feel free to ask...there's many, many people here who know much more than I. I can just share my experiences.

Take care, sally

Old 11-14-2008, 02:59 PM   #5
Join Date: May 2008
Location: nowheresville, PA, USA
Posts: 118
ntbd HB User
Re: CHOP-R therapy

- doxil is liposomal doxorubicin, it's a milder form, sort of encased in fat globules. Less hair loss results, too.

- yes, they'd measure his ejection fraction beforehand to see if he qualifies, most accurately with a MUGA scan. Adria is a known HEART-KILLER. A person only can get a lifetime limited number of doses, legally.

- yes, those are OTC antioxidants. They likely ameliorate the damage from Adria, but don't lessen the efficacy of the drug.

- why is he accumulating fluid? Is it effusion from the lymphoma?

-every 3 weeks CHOP sounds like a greater interval than a younger person would get (every 1 week), so they're taking it easy on him

-most respond to CHOP. >90% IIRC

-Rituxan is as mild as you can get. It's also very interesting stuff. Imagine a huge number of tiny tiny little flags, that stick only into B-cells. The flags tell the body: kill this cell. So CHOP is like a shotgun which can harm lots of cells, but Rituxan only gets the B-cells.

Sally thankfully brings up the germ-free necessity, since the immune system gets so weakened. even get a new dish washing pad, e.g.

But, the issue of fatty/sugar food is very tricky. People with cancer and people getting chemo are disposed to blood clotting. As are elderly. As are those with reduced mobility. Is your dad getting an anticoagulant like enoxaparin (Lovenox)? A "single fatty meal" can kill. But wasting can also be so bad. There are appetite stimulants like Megestrol.

----- prednisone (the P in CHOP) causes fluid retention unless salt is restricted. prednisone can cause diabetes if high GI foods are not restricted. (Pred is given to ameliorate the effects of the cytotoxic drugs) ----------

make sure he drinks plenty of water throughout, especially in case of Tumor Lysis Syndrome

If you want to do all you can for him, then please take all of these words as sign posts and you can learn what you need

Good luck to your dad. Mine didn't make it... but he had a much worse form.

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