Chapter 9: Round 1 of Treatment

February 16, 2023, marked the initiation of my treatment—a journey into the unknown realm of chemotherapy, a domain I had never ventured into before. With limited firsthand experiences to draw upon, the uncertainty was palpable. Fortunately, being a participant in an official clinical study meant having a Study Coordinator by my side. Jessica, a beacon of support, proved to be an exceptional resource, guiding me through the myriad of appointments and steadfastly attending each session once my treatment commenced.

Armed with a trove of information, Jessica, along with my oncologist, presented me with detailed material delineating the medications slated for the trial and a comprehensive list of known side effects. In the meticulous landscape of a clinical trial, every side effect became a vital entry in my daily journal, meticulously chronicling the time I took the study drug.

The clinical study unfolded across 6 rounds, each spanning 28 days. In the initial trio of rounds, the regimen kicked off with Rituximab, administered via IV on day 1. Notably, Rituximab isn’t chemo but an antibody therapy designed to bolster the immune system’s ability to combat cancer cells. This first introduction of Rituximab to my body was cautiously delivered spanning around 4 hours. I was closely monitored by my exceptional chemo nurse, Noreen.

Before the Rituximab infusion, I received what I fondly call the “cocktail” of side effect minimizing medications—a blend of acetaminophen (Tylenol), dexamethasone (corticosteroid), diphenhydramine (Benadryl), and ondansetron (anti-nausea). This concoction worked wonders, shielding me from nausea and allowing me to tolerate both Rituximab and the forthcoming Bendamustine remarkably well.

Post-Rituximab, the next phase involved a 10-15 minute infusion of Bendamustine, an actual chemo agent necessitating additional protective gear for the nursing staff due to its toxic complexities. Bendamustine operates by impeding cancer cell growth, paving the way for their subsequent destruction by the body’s mechanisms.

Following the completion of Bendamustine, I was introduced to the study drug, acalabrutinib—an oral chemo component scheduled for intake every 12 hours, starting at 7 pm that first night.

February 17, 2023, ushered in day 2 of the inaugural round, marked by the familiar Bendamustine infusion. The pre-infusion cocktail, minus the steroid, served its preventive purpose well.

In retrospect, I weathered the two days of treatment admirably, imbibing a wealth of knowledge from Noreen. Departing with an arsenal of medications designed to preempt any potential nausea and fortified with antibiotics to bolster my diminished immune system, I headed home, ready to face how this treatment would effect me physically in the next 26 days.

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