Complete Remission

Here is a picture of (from left to right) my mom, Dr. Pinter-Brown, me, and my dad at UCLA Medical Center on February 2, 2010.

I'm happy to write that I'm now in complete remission. Today I met with my oncologist, Dr. Pinter-Brown at UCLA Medical Center, and she says I look great. She checked for any lumps in my neck, jaw, under arms, and stomach, and found none! We also did a blood test and my platelets look normal. Plus, my anemia is improving. All of this as you can imagine was very welcomed news to my family and I. We were at the doctor's office for two and half hours, but after hearing the good news, the wait didn't seem to bother us as much.

However, more importantly this appointment gave me the opportunity to ask my doctor some important questions about my health and future. Before the appointment I wrote up a list of questions (I can't help but be a reporter!!) to ask Dr. Pinter-Brown. It was funny because my doctor was impressed by how thorough my questions were, she could tell I do this for a living! Here is the list of questions and my doctor's answers. I hope they are as helpful to you as myself.

1. Am I cured or in remission?
Right now I'm in "complete remission." This means they don't see any new cancer in my body, but I'm not yet cured. The definition of being cured is being cancer free for 5 consecutive years. The doctors haven't performed any scans on me yet, but they don't believe I have any new forms of cancer in my body. This is because they did a PET/CT scan right before I started my treatments and didn't find any new forms of cancer. Then during the actual treatments no new forms of cancer can develop, so now I should be cancer free. The real test will be my consecutive scans to see if any new forms of cancer develops in the time after my treatments.

2. Should I be taking any vitamins or supplements?
No, not necessary. Just make sure I eat healthy and get all my food groups. (But I feel like this is easier said than done!)

3. Are there certain foods or drinks I should avoid? No, just eat healthy. I now have no restrictions! (coffee here I come!!)

4. What type of exercise routine should I start? It important for me to get some regular exercise, but I need to slowly ease my body into working out again. I should not push my body to the point of exhaustion, but getting some exercise is a good thing.

5. When will I know if I will be able to have kids? Dr. Pinter-Brown thinks I should be able to have kids. The only thing that may happen is I might enter into menopause earlier than most women.

6. Do I have a greater risk of developing cancer again? Yes, especially other forms of lymphoma, and cancers to my head and neck. This chance increases as I get older, but the truth is everyone is at an increase chance of developing cancer as they age. Sometimes there is no rhyme or reason why cancer develops, and all of us could or could not get it in our lifetime.

7. If I do develop cancer again, would I receive chemotherapy and radiation again? Yes. I would not receive the same type of chemotherapy, R-CHOP, but there are other forms of chemotherapy that the doctors could administer, heaven forbid I do develop cancer again.

8. What is the next step for me? Scans? Heart echo? Blood tests? The next step for me would be to have another PET/CT scan in 3 to 4 months. Dr. Pinter-Brown recommends I do the scan at UCLA. Then after the first scan I would do another one in 6 months. She doesn't recommend doing the scans too often because the x-ray beams are very powerful and could be damaging to my body, but the scans are important to make sure the cancer doesn't redevelop.
As far as my heart, I have to go back to my cardiologist for another heart stress test. Dr. Pinter-Brown wants to continue to monitor my ejection fraction to make sure it is not getting worst. Right now I have an appointment to meet with my cardiologist in the beginning of March, but I'm going to try to move it earlier, like the middle of February.
Receiving blood tests every 3 months will also be very important to monitor my health. Dr. Pinter-Brown recommends coming in every three months for a blood test to monitor my platelets and make sure nothing is out of the ordinary.

9. Will my heart return back to normal? No. Dr. Pinter-Brown says I can't rebuild my heart muscles. The adriamycin in R-CHOP is so powerful that it could continue to weaken my heart as time goes on (but we're hoping it doesn't). She seems to think we caught it early enough that it won't do too much damage to my heart. Plus, there are things I can do to make sure my ejection fraction doesn't get worst. For instance, make sure I don't smoke, develop high blood pressure, or become over weight. The problem with a below normal ejection fraction is it could lead to cognitive heart failure, and I don't want that. It was just surprising to me that I couldn't do anything to improve my heart muscles, I wish I could do something to help.

10. Is there any way I could check for a re-occurrence of my cancer myself? Signs? Symptoms? I just have to pay attention to my body, but I should not worry too much about it. If I recognize a lump or a swollen part of my throat or neck I should go to the doctor and get it checked out. Some other symptoms of lymphoma are: weight loss, Night sweats, and unexplained fevers.

11. If I haven't developed any new side effects now, will any other ones develop? No. The only thing is my heart could get worst and I'm at a greater risk of developing another form of lymphoma.

12. Which side effects are permanent? Possible decrease in saliva, but I have already notice that is improving, along with my dry mouth, my hair returning, and my fatigue beginning to diminish.

13. Should I be concerned about my ITP coming back again? No. Plus, when the doctors do the blood tests every three months they'll look at my platelets and monitor that too.

14. Should my future doctors look out for anything in particular? Not really anything in particular. I just need to tell them my medical history and they'll look out for any new forms of cancer.

15. How and when should I return back to work? I can return back to work, but I need to ease into it. My body has gone through a traumatic experience and it is important that I slowly return to my normal life. Actually my doctor recommends I start out part-time for the first few weeks and then work up to full time. But the good news is I have won the fight and I'm ready to move on!!
Danielle