Interview 16
Age at interview: 44
Age at diagnosis: 33
Brief Outline: Non-Hodgkin's lymphoma diagnosed in 1997 after finding a lump in his neck. 'Watch and wait' policy adopted. Later treated with various chemotherapies, a stem cell transplant, and a radiolabelled monoclonal antibody. Now offered a cord blood transplant.
Background: Client Services Assistant, married but separated shortly after interview, two children aged 11 and 15. Ethnic background: White British.
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He presented a lump in his neck to his GP, who also detected lumps in his groin. He was referred to a haematologist who biopsied one of the lumps. This showed that he had follicular non-Hodgkin's lymphoma, which he was told was uncommon in his age group, and the consultant sought a second opinion. The diagnosis was confirmed and a policy of 'watch and wait' adopted rather than starting treatment. He was unsettled by being told he had cancer but that he didn't need treatment. So for four years he just had a consultation every few months.
After four years the lumps in his neck and groin had grown and were causing discomfort so his consultant decided to give him oral chemotherapy monthly (CMD). During this treatment he was informed that his test results had been reviewed by another specialist who thought his disease had progressed further than originally thought. So he was put on more aggressive intravenous chemotherapy three weekly for three months (CHOP) followed by high dose chemotherapy (BEAM) and a stem cell transplant. This put him into remission.
Eighteen months later he noticed the lumps were regrowing so he was put on chemotherapy again (FMD and rituximab), which didn't seem to work. He was then put on rituximab alone, which worked for a while, and then a radiolabelled monoclonal antibody (Zevalin) that also seemed to work, since which time he has been well, although the lumps are regrowing again.
He has recently been offered a cord blood transplant, which involves transplanting matching stem cells from the umbilical cord of a newborn baby. The risks are high and he has a difficult decision to make.
After four years the lumps in his neck and groin had grown and were causing discomfort so his consultant decided to give him oral chemotherapy monthly (CMD). During this treatment he was informed that his test results had been reviewed by another specialist who thought his disease had progressed further than originally thought. So he was put on more aggressive intravenous chemotherapy three weekly for three months (CHOP) followed by high dose chemotherapy (BEAM) and a stem cell transplant. This put him into remission.
Eighteen months later he noticed the lumps were regrowing so he was put on chemotherapy again (FMD and rituximab), which didn't seem to work. He was then put on rituximab alone, which worked for a while, and then a radiolabelled monoclonal antibody (Zevalin) that also seemed to work, since which time he has been well, although the lumps are regrowing again.
He has recently been offered a cord blood transplant, which involves transplanting matching stem cells from the umbilical cord of a newborn baby. The risks are high and he has a difficult decision to make.
At his third relapse a man became depressed because he felt his doctors no longer knew how to...
At his third relapse a man became depressed because he felt his doctors no longer knew how to...
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So it got to the point where I was getting a little bit anxious because I could see that the consultants didn't really know what to do at that stage, they didn't really know what avenue to go down, you know, treatment-wise. So I suppose it, I was getting a little bit, I got a little bit down and things started going a bit, you know, I sort of went off the rails a little bit, I was getting frustrated and I was getting depressed because I thought I'd beaten it and then it came back again, and I suppose I was feeling that the consultant, I could see the consultants, you know, when they get a little bit, when they started getting confused as to what to give you as treatment, I think it rubs off on, as a patient, you know, it rubs off, you sort of come away thinking, 'Well they don't know what to do with me now, what's going to happen?'
So at that particular time I needed to speak to someone and my local authority got me in touch with a counsellor, which I started seeing, who was an expert in cancers. So I then started seeing her and that was great, just what I needed at that time. And she said, 'Look, don't worry, there's loads of things out there and they're just obviously, they're just like waiting to see what could be available.' And I just remember them saying to me that it was quite unusual for someone to relapse so quickly after having a stem cell transplant, you know, especially in someone my age, they don't normally see it.
Had been geared up to have treatment so was shocked to be told he would be put on watch and wait...
Had been geared up to have treatment so was shocked to be told he would be put on watch and wait...
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So I sort of come away, my wife and I come away from that interview and I just remember just being in shock really because they, I was geared up to having some form of treatment and then to come away and like they was going to leave me, you know, just didn't seem right. So that was '97 and so it was just a question then of going backwards and forward to my local hospital, having scans and bone marrow biopsies and just basically going back to see my consultant every few months.
This went on till 2001 where the lumps that I had in my groin, I had some under my neck, they were sort of getting quite big and a bit uncomfortable, and it was that stage when they decided that they were going to start treatment.
Was concerned during watch and wait that his lumps were growing bigger and with hindsight feels...
Was concerned during watch and wait that his lumps were growing bigger and with hindsight feels...
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Looking back on it now with all the experience that came afterwards, do you still think that was the right decision?
There's sometimes where I still stick by my feelings that they left me too long because this was, this became apparent, I feel, when they, when I started treatment in 2001 and they put me on the CMD drug for three months, they also, they just, and then all of a sudden it came from another haematologist, consultant, who said, 'No actually we feel he's gone further down the line than you said he had,' so I felt there was this conflict in opinions between the two teams. And then all of a sudden like I was rushed off to meet another team of consultants who then put me on a more aggressive treatment, so I felt' did the first lot of consultants maybe get it wrong and leave me too long when they could have treated me earlier?
Had to be treated with Zevalin in a different hospital; explains how it was given, how he felt...
Had to be treated with Zevalin in a different hospital; explains how it was given, how he felt...
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So this treatment came available and I went to another local hospital, I went to another hospital to have this treatment and it seemed to work. And since then, since July 2005 I've been quite well.
How did you feel about having a radioactive drug put into you?
I was, obviously I asked the question that, 'Am I going to be safe walking, you know, having a radioactive drug going around my body?' And it was quite funny really the only thing they said was, 'When you go to the toilet make sure you don't splash anywhere, and wash your hands properly'. I don't know what that meant like thinking am I going to burn things or something, you know? But it wasn't like that at all. But no it was fine. And I didn't have any symptoms at all, it didn't make me feel sick, I didn't have nausea at all with it. Oh sorry no I did, I did have a little bit straight after I had the Zevalin, the first few days when I came home I was, I did feel quite sick after that but that soon passed.
Were you actually sick?
No just really nauseous but I was on really good tablets, they were good tablets that you can get that stops nausea.
So how do they administer this Zevalin stuff?
It's in a syringe and it takes fifteen minutes to give, and it's just like a, just a syringe full, and that's it.
Right, and how many doses of that did you have?
That's just the one dose, just one dose.
Oh really.
Yeah what I had to have was, the week before, I had a course of rituximab and then the day of the Zevalin in the morning I had another course of rituximab and then in the afternoon I had Zevalin straight on top, and they find that the combination of the two works really well. And that was in July and we are now in January and I'm doing really well.
Had reflexology from a volunteer during treatment, which was relaxing and helped him to sleep; he...
Had reflexology from a volunteer during treatment, which was relaxing and helped him to sleep; he...
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Reflexology, yes.
Was that just for the relaxation effect or did you believe that it might help cure your illness?
It was, no, it was, when I was having treatment, when I was in the middle of treatment once in my local hospital they had someone come round offering, they had a reflexologist that came round and offered, did anyone want their feet doing while he was there? So I said yes. And so he done that and I found that while I was sitting there and I had the treatment going through me, it makes you feel quite tired anyway, but I just found that I just felt that it was quite relaxing while I was sitting there having treatment. So I said to him, 'Would I be able to have this on a permanent basis?' And he said, 'Well because you're having treatment,' which is quite, and I didn't know this but most authorities do it, there's therapists give up their time and they tend to voluntarily do reflexology or massaging in their own time. And this person, that's what he did on a Tuesday, he helped out at the unit where they give the chemotherapy.
So I had a couple of sessions with him and I didn't, he said to me, 'It's not going to help you, this is not going to help your illness, it's not going to do anything at all, it's just going to relax you', because when you're on certain chemotherapies and that you can't sleep at night, you know you, with the mixture of drugs that you're on, I was on so many drugs that I found that I couldn't sleep at night, I was getting up early hours of the morning, coming downstairs, watching a bit of telly, going back up to bed again. So it got to the stage where I needed to do, find some form of relaxation. And so I went to a couple of sessions of this and I found it quite good. But I also think that if people can get tapes and CDs they're quite helpful as well, and that's another thing that I did. At night when I went to bed, I used to listen to relaxation tapes and CDs, which are really helpful.
So then I stopped going because I was going through quite a good period so I felt that I didn't need that then. But I've recently just started having reflexology again, and even though I feel quite well it's really beneficial, it really relaxes you and you can have a really good night's sleep. So I feel it's, anyone going to a reflexologist or an aromatherapist, and they're pretty good, they know, you've got to tell them that you're having treatment and what sort of cancer you've got, and they're quite good, they know what areas to stay away from. And with me the reflexologist I've got now she knows what areas to, not to work on, you know, in the lymphatic system. So but other than that it's really good.
Have you used any other types of complementary therapies at all?
No I haven't, no I've only had reflexology. They're quite, I had a couple of sessions of aromatherapy massage where they do the shoulders and your back and that was quite good. But I tend to mainly stick with reflexology because, you know, they can do all your, all the parts of your body, they can work on all different parts of your body just through the feet, so I tend to stick with that one.