DAY 47: ABVD – "a necessary evil"

ABVD is almost always given as an out-patient regimen.  Speaking from my experience, I am being treated at an out-patient cancer department. I usually spend 90-120 minutes there – once in two weeks. I take the liberty of calling it “necessary evil” because along the cancerous cells it kills off the good ones, too.

 Before each chemo, I visit my oncologist who makes out a prescription which I bring to a pharmacy department – the order is filled here and the dose of my chemo is prepared (takes around half an hour).

ABVD is an abbreviation of four drugs: Adriamycin, Bleomycin, Vinblastine, and Dacarbazine that are given to me to help me throw off the Hodgkin's lymphoma.

So, let's take a closer look at each of them:

ADRIAMYCIN – the orange/red drug that is usually given first. I am given approximately 3.5 dl of it each time. It slowly flows into my veins. As far as I know, it hits the darned Hodge the hardest. The lymphatic cancer is not the only one that is treated with adriamycin. Many others use it and it is often called “The Red Devil” (no wonder!). This little devil causes nausea, hair loss and potential heart problems – depending on the dosage. Less acute, it turns one’s urine orange/red – so don’t freak out when you first see it :)

BLEOMYCIN – comes out in a syringe and the liquid is pushed slowly into the veins. It is transparent and it is known to cause pulmonary side effects – not right away, but down the road it can impair the function of the lungs. One’s reactions to chemo vary, some people get allergic reactions, some get fevers from Bleomycin. But in my case, so far so good.

VINBLASTINE – similar to Bleomycin in looks and administration. This one comes with an amazing story. Vinblastine was first isolated by Robert Noble (not to be confused with Alfred Nobel) and Charles Thomas Beer from the Madagascar periwinkle plant. Vinblastine's utility as a chemotherapeutic agent was first discovered when it was crushed into a tea. Consumption of the tea led to a decreased number of white blood cells, therefore, it was hypothesized that vinblastine might be effective against cancers of the white blood cells such as lymphoma. I do not know whether this discovery was a lucky coincidence, but it sure made many people’s lives easier.

DACARBAZINE – this one is a drip and it takes around one hour until it gets into my blood stream. It comes in two black bottles (one liter altogether) – to be protected from sunlight. The D is probably the one most likely to make you feel sick (highly emetogenic). It also causes sterility, immune suppression, headaches, fatigue etc.

A bit of eggheadism: Dacarbazine is a member of the class of alkylating agents, which destroy cancer cells by adding an alkyl group (CnH2n+1) to its DNA. So, the DNA of some of my cells is being changed, nice…I hope it will pay dividends.

  

Speaking of immediately visible side effects, I suffer from fatigue during the first 4-6 days after a dose. The next morning after chemo is probably the worst, but not as bad as many may think. People react differently, but I would liken my feeling to that of being hung over. I go out of my way to drink as much still bottled water as possible to help my body flush the evil cells out.