The regimen

So this time things are taken up several notches on the treatment scale. The fact that the cancer has retuned so soon has been labelled "dissapointing" by prof Joshua and means that the same treatment as she had before is not an option (it may have been considered if it was 12 months or more).

Similar to antibiotics the body builds up an immunity to chemo so totally new drugs are given this time around (although their purpose is the same and are chemical "cousins" to the first lot). The side affects are a bit more gruelling though

Chemotherapy

there will be 3 chemotherapy sessions which will each require her to be hospitalized for 2 to 3 weeks. This is because the risk of infection it too high due to the drop in white blood cells

the chemos are called r-dhac, r-give and r-cbv - with the "r" being rituximab which is the marker drug from last time


bone marrow (stem cell) transplant

after the second chemo shanean's stem cells will be harvested and then frozen for later as the final round of chemo will destroy all her bone marrow and the stem cells will be put back in her to grow it back

side effects and care

it seems that infection will be a near certainty during this time - such as pnemonia. Infections will probably come from inside her own body rather than from external sources as the protective layer around the stomach will be removed therefore making her exposed to all the normal bacteria that we always have in there. In saying that the doctors still recommend no visitors with colds or flus and masks/gloves otherwise

her red blood cells will also be affected meaning blood transfusions will be required - having low platelletes also means she will bruise and bleed easily and will therefore have to be careful (brushing teeth particularly)

prognosis

the "salvage" rate (as they call it) is 50 to 60 per cent - they are expecting her to respond due to age and good health (as before) - if we could just stop the damn relapses we will be fine

if it doesn't work this time they can't use her own stem cells again so will need bone marrow transplants from a suitable donor - probably siblings.