Non-Hodgkin’s Lymphoma Survivor
|Carolyn Kloke, Anacortes, Washington|
“I woke up at 1 a.m. in extreme pain and took an antacid,” Carolyn recalls. “I wasn’t ill, but called the doctor the next day. My nurse practitioner found a mass, and I learned of the non-Hodgkin’s lymphoma diagnosis after a CT scan in December 2003.
“I decided not to go back to work during my treatment,” Carolyn recalls. “The doctors kept using the word ‘aggressive’ and I didn’t know to which they were referring to, my cancer or my treatment!”
After six treatments of Rituxan, an immunotheraphy drug, and CHOP—one of the most common chemotherapy regimens for treating Non-Hodgkin's lymphoma that consists of Cyclophosphamide, Adriamycin, Vincristine, and Prednisone—with a local oncologist, Carolyn’s cancer wasn’t going into remission like her doctors had hoped. Carolyn decided to continue her care at Seattle Cancer Care Alliance in August 2004 and to participate in a clinical study under the care of medical oncologist, Dr. Ajay Gopal.
She and her husband moved into the Pete Gross House in Seattle in August 2004 for her treatment on the clinical trial at SCCA. They were there for about 10 weeks. “We were very appreciative to have this place to live, and the convenient shuttles to the hospital and SCCA,” Carolyn recalls.
For many patients with non-Hodgkins lymphoma, the standard treatments can do more harm than good — a frustration that led scientists in the Clinical Research Division at Fred Hutchinson Cancer Research Center to search for a better way. Their findings, (published in the Journal of Clinical Oncology), hold promise for future therapies.
Non-Hodgkins lymphoma can strike at any age but most often occurs in people in their 60s. Once it's in remission, it often returns. "Unfortunately, most people will relapse after their primary therapy, and most therapies in the past for patients with relapsed lymphoma have been targeted to younger adults," said Dr. Gopal, lead author of the study.
Physicians are reluctant to use the standard treatments of stem cell or bone marrow transplantation on older adults, believing it's too toxic. “That basically excludes half of the patients that have this diagnosis," Dr. Gopal said.
Working with radioactively tagged monoclonal antibodies, y-shaped proteins that can be created to bind to a certain specific substance — in this case, tumors — physicians are able to deliver very high doses of radiation to tumor sites, sparing the surrounding organs. Total-body irradiation or high-dose chemotherapy targets healthy cells as well as tumor cells, so researchers believe the targeted approach to be a safer and more effective treatment for older people.
Bone Marrow Transplant
Under the care of Dr. Gopal, Carolyn received radioactively tagged monoclonal antibodies and high-dose radiation to kill any remaining cancer cells. She remained in isolation in a lead-lined room at UW Medical Center for 10 days before she received her stem cell transplant.
“Except for my husband, who visited outside the room and my family on the weekend, I was pretty lonely,” Carolyn recalls. “I tried to ride a stationary bike they have there to pass the time.”
Prednisone was the hardest drug for Carolyn, she recalls, because it gave her headaches and pain. “I felt so bad that I just wanted somebody else to tell me what I had to do. It was a bizarre feeling. I became good friends with my special chair.
Carolyn credits her husband of 40 years for his wonderful care during her recovery after the transplant. “He is rather Type-A, and busy himself. He was putting together a rock climbing guide at the time, which was good so we had some time off from each other.”
Now that she is healthy again, Carolyn says that getting cancer was almost like getting a gift. “It made me reprioritize my life and priorities.”
Life is back to normal and it’s good, she says. Carolyn spends her time volunteering at her local hospital and stays busy with her church. She knits scarves and sells them at Relay for Life, to which the proceeds are donated.
‘The "3 F's:" Faith, Family, and Friends are priorities and now I’m blessed with granddaughters, who were born in 2006 and 2007,” Carolyn says.
Since her transplant in 2004, Carolyn says “I never forget what happened to me, but it’s certainly not on the front burner like a few years ago. I’m just very thankful.”