• Hodgkins Lymphoma-did 8 chemotherapy treatments and now my oncologist recommending radiation, i refused radiation and doctor then suggested another 4 treatments of chemotherapy, if PET scan is clear and cancer is gone why do more? what's your experience?

    Asked by mommyNY on Saturday, February 11, 2012

    Hodgkins Lymphoma-did 8 chemotherapy treatments and now my oncologist recommending radiation, i refused radiation and doctor then suggested another 4 treatments of chemotherapy, if PET scan is clear and cancer is gone why do more? what's your experience?

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    9 Answers from the Community

    9 answers
    • saltermd's Avatar

      For early stage HD, 2-4 cycles of ABVD (that would be 4-8 individual treatments - each cycle is 2 administrations) followed by radiation to the involved lymph nodes is a widely accepted standard-of-care.

      There is some controversy lately as to whether one can skip radiation and add additional cycles of chemotherapy - this is an issue patients should discuss openly with their doctor. Both chemo and radiation have potential long-term side effects, so patients need to consider which treatment option is most appropriate for them with that in mind.

      I think the PET/CT is reasonable to obtain now, and could offer valuable data. However, even if the PET shows your cancer is "gone", additional treatment is often advised to obtain full remission.

      Ask your doctor to show you the NCCN treatment guidelines - they are current, evidence-based outlines of how to approach patients with various cancers. Seeing this could reassure you that your doctor is prescribing the right treatment for you.

      Best of luck.

      over 4 years ago
    • GregP_WN's Avatar

      I had Hodgkins twice. The first time had 6 treatments of chemo, and 25 radiation. Was supposed to have more radiation but the brain trust decided I didn't need anymore because the scans looked good.....4 months later it was back. Yes treatment sucks, it's hard, but trust me, it's harder if it comes back. the next time my treatment was twice as long and hit me harder. Take the treatment whatever the Dr's suggest. I am not a dr. I trust that those who I have entrusted my life to know more about it than I do, so if they think I need something, I am all in.

      Good luck to you in the rest of your treatments, I hope they are quick and easy for you!

      over 4 years ago
    • nancyjac's Avatar

      A clear Pet scan doesn't necessarily mean you are cancer free. Scans generally can't pick up individual or a few scattered cells. Often radiation is the treatment of choice to get rid of any lingering cancer cells. Having had both chemo and radiation, I would opt for the radiation over additional chemo. My side effects from radiation were minimal but the various side effects from chemo make me sick as a dog a for one week out of every three.

      over 4 years ago
    • pattycake's Avatar

      I was diagnosed with Hodgkin's stage II in May, 2011, did not have surgery other than biopsy and having a port inserted. I did not have radiation, in fact my Oncologist didn't even discuss it. I had 12 Chemo treatments (ABVD) over 6 month period. I was not nauseated....thanks to Emend (medication) taken day of and 2 days after each treatment. My 3 Pet/CT scans have been clear, one of which was done after the 4th treatment but I too, continued with 8 more treatments. I feel the same as you about radiation; afraid of side effects; also read it might lead to other Cancers. So far, no apparent side effects of Chemo. My Oncologist is confident it won't come back, I hope he is right. Good luck to you.

      over 4 years ago
    • mommyNY's Avatar

      thanks everyone!
      i do speak to my doctor openly this type of relationship is very important to me. i have some medical expertise as i am a nurse myself. the standard of care can be found online as per googling options.
      i am being treated at an awesome facility, memorial sloan kettering in NYC. although, it is a type of conveyer type treatment for cancer (my view)
      although docs suggest radiation, i refused it! it has too much risk for cancer down the line (this part is NOT discussed) and docs do care to treat in the moment and what can happen 20 yrs down the line the doc is not that concerned. i am in my 30's i consider myself fairly young i am refusing radiation and it's my choice. i choose to have 12 chemo treatments as for treating Hodgkins lymphoma.

      so if PET scan is clear cancer is not gone? once PET scan is clear means no cancer. yes it may may not come back but Hodgkins has good outcome this is what my doc keeping saying.

      radiation is specific to the tumor is there are "cancer cells" out there those would be killed by chemo, radiation would be aimed at tumor.

      love and light to everyone!
      have blessed day!

      over 4 years ago
    • nancyjac's Avatar

      While radiation is as targeted as possible, it is not necessary aimed at a tumor. I have IBC and don't have well defined tumors. I still plan to have radiation on that breast following chemo and mastectomy, regardless of PET results. It may not be the best choice for everyone, but additional chemo would just be too hard on my already compromised immune system. A clear PET scan may or may not mean you are cancer free. PET picks up hot spots that may or may not be cancerous, but in order to show up, there has to be enough immune response activity going on to be within the sensitivity range of the scan.

      over 4 years ago
    • leepenn's Avatar

      The issue with PET/CT is one of resolution. It CAN detect greater than millimeter sized tumors but cannot detect less than millimeter sized tumors. So, the idea that your PET/CT is clear means that you have no detectable cancer by that technique. You may still have small cancers remaining that cannot be seen on the PET/CT scans.

      over 4 years ago
    • threecs' Avatar

      The same thing happened to me. My scans were clear after 4 treatments and it was real hard for me to understand why I would need to continue. They have studied this for years and the best results are the combo. I did it because I hope I would never have to do it again. Radiation was not anywhere close to being as bad as chemo. It's quick and easy and worth it if it means no more chemo.

      about 4 years ago
    • GregRx's Avatar

      Like saltermd said according to current guidelines this is standard of care.

      My PET scan was also clean after my Stanford V regimen when I had completed my 12 weeks of chemo.

      They went ahead with the 30+ radiation daily treatments afterwards as the long term remission rates are better with this therapy.

      Still remission free after 14 years.

      It is your choice though! I tolerated chemotherapy WAY better than radiation re: side effects.

      about 4 years ago

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