Risks and Benefits of Drug Cocktail
- R-CHOP is a combination of five drugs used to treat B-cell non-Hodgkin lymphoma
- It produces a remission in about 60% of people who take it
- Each of the drugs in the combination can cause their own side effects, which include fever, hair loss, nausea and vomiting, weight gain, and high blood sugar levels
- R = Rituximab (Rituxan) — a monoclonal antibody
- C = Cyclophosphamide — a chemotherapy drug
- H = Doxorubicin hydrocholoride (Hydroxydaunomycin) — a chemotherapy drug
- O = Vincristine sulfate (Oncovin) — a chemotherapy drug
- P = Prednisone — a steroid drug
All five of these medications work synergistically to treat lymphoma. But with any cancer treatment, and especially one that contains multiple medications, side effects are a concern.
Read MoreWatch for a Fever
Your bone marrow is the spongy material inside your bones where new blood cells are made. White blood cells are your immune system’s army of infection fighters. “If your white blood cell count is too low, you can’t fight off bacterial infections,” Dr. Phillips says. When your white blood cell count is low, you can develop what doctors call febrile neutropenia. Neutrophils are a type of white blood cell. “If those dip to less than 500, we’re pretty concerned that the patient could have an infection,” she says. One telltale sign to look out for is a fever higher than 100.4 degrees Fahrenheit.Your doctor will do blood tests before each treatment to check your neutrophil levels. “We’ll make sure that it’s safe, that their neutrophil count, their white blood cell count is high enough to administer the treatment,” Dr. Phillips adds.
Other side effects from the three chemotherapy drugs include:
- Bruising and bleeding
- Tiredness and weakness
- Shortness of breath
- Nausea and vomiting
- Hair loss
- Diarrhea
- Mouth sores
- Weight loss
Doctors have treatments that can prevent or reduce side effects such as nausea, vomiting, and tiredness.
Side Effects from the “R” and “P”
Other side effects that can happen from this treatment stem from Rituxan, the “R” in R-CHOP. Sometimes people can have an infusion reaction. “It usually happens on the first cycle and goes away,” Dr. Phillips tells SurvivorNet. It’s easily treated, and we can pre-medicate for it.”
The “P” in the drug combo, called prednisone, causes side effects that are more typical with steroid therapy. Those can include high blood sugar levels, difficulty sleeping, and weight gain.
How Well Does R-CHOP Work?
If you’re about to put yourself through a treatment that can cause a myriad of side effects, you want to know that it’s going to be an effective cancer fighter. How well R-CHOP treatment works really depends on what type of lymphoma it’s used to treat.
“For diffuse large B-cell lymphoma, depending on what stage the lymphoma is and what the cell of origin is, R-CHOP has very high complete remission rates in the range of, I’d say, 60%,” Dr. Phillips says. But, she adds that how long those remissions last depends on factors such as a person’s age, their stage of lymphoma, and what type of cell (B cell or T cell) their cancer started in.
Before you start on R-CHOP, make sure you understand how your doctor expects it to help your cancer. Also find out what side effects it could cause, and what (if anything) you can do to relieve those side effects.
Reviewed by Dr. Sairah Ahmed, associate professor, Department of Lymphoma/Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center
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