Scan Results

Well, no surprises with the scan results. The Rituxan knocked things back some, but not enough for a full Complete Response.

Some of the nodes have shrunk down to normal. Others, especially the deeper ones that were causing the leg swelling, have shrunk by about half, though still not back to normal. (From about 6 cm down to 3 cm, or 2 inches down to 1 inch. Normal is about 1 cm, or a third of an inch.)

This is all in line with what I expected, as I said last time. The leg is still a little swollen, though much better than it was, so I knew there probably wasn't a Complete Response. That's rare, anyway -- maybe less than 10% of patients get a CR from Rituxan alone.

So the good news in all of this is that I did get a response to the Rituxan. Some folks aren't that fortunate, and the cells stick out their tongue at the Rituxan and the nodes actually grow instead of shrink. So we're happy about getting a response.

We talked about the next step, too, so we'd be prepared when the time comes. He thinks going back to watching and waiting is the way to go at this point, and I agree. The Rituxan may still continue to work for a while, so it's possible things will shrink even more. If things get a little better, or stay about the same for the next 6 months, then we'll try another round of Rituxan. If things get worse, we'll go with one of the milder forms of chemotherapy, probably CVP. I asked about some other options, like Fludarabine (which I wouldn't want to do, given some of its possible long-term side effects) and Chlorambucil (which I still haven't researched enough to be comfortable with), but he seems to favor CVP and so do I.

I think Isabel was a little down when we were done, especially with the discussion of chemo. There's a decent chance the Rituxan will hold things off for a while, and we'll just repeat Rituxan infusions for a couple of years. But, for me, I need to know what the next step is going to be, so I dragged out that chemo conversation for a while. It helps me prepare myself mentally. It's always hard on the caregivers, as I've said before -- keep them in your thoughts and reach out to them when you can.

So, bottom line: the Rituxan did its job in knocking things back a little, and now we're waiting to see if it keeps holding things in check. I go back to see Dr. R in 6 weeks. Blood tests will give us a sense of how things are going, but mostly it's going to be my own observations of how I feel that will tell us where we're at.

And I feel...

Good! Sing it, James.........