Greg has cancer

As many of you know, we took him to the ER because he was experiencing intense abdominal pain. After a CT Scan, the doctor found he had an intussusception (his colon was telescoping in on itself). Because he was over 3 years old, they would have to surgically repair his colon and would follow common procedure and remove his appendix as well. The surgeon found the leading point that caused the intussusception to be a mass with swollen lymph nodes. He removed that mass and reconnected his colon. Greg was in the hospital healing for 7 days. He couldn't eat or drink for 5 of those days. He was in good spirits the whole time!

The pathology report of the removed mass stated that it was malignant. Greg was diagnosed with Burkitt's Lymphoma on September 9, 2010. Burkitt’s Lymphoma is under the umbrella of Non-Hodgkin’s Lymphoma – a cancer of the lymph system (specifically attacking B-cells), which is a group of tissues and organs found throughout the body. With non-Hodgkin’s lymphoma, the body makes abnormal lymphocytes which grow out of control, thus classifying them as cancerous. The cells are considered abnormal because they do not perform their proper function of disposing of non-self cells – which are harmful cells that enter the body as infection and so forth. These cells collect and cause swelling in the lymph nodes. Due to the location of the tumor, he is considered a Stage 2 within Group A. This staging helps determine the treatment plans, which are predetermined by the Children’s Oncology Group and are universal, meaning that the same treatment will be given wherever we go.

The tumor was completely resected, meaning the margins around the area were clear of the cancer cells, which puts him at a 98% cure rate using the COPAD (or CHOP) chemotherapy approach. COPAD is code for the different drugs that will be administered during chemotherapy: Prednisone, Vincristine, cyclophosphamide, Doxorubicin, and G-CSF. He may also include Rituximab. Chemotherapy drugs are targeted at all growth cells – the good and the bad. The almost certain side effects of these drugs include lowered immune system, hair loss, and increased appetite. The possible side effects of these drugs include infertility, bladder damage, anger, and others. Thus, our desire to use Rituximab as explained below. We have also been told that since he will be undergoing only two sessions of chemotherapy the amount of drugs he will be getting is very limited, thus greatly lowering the possibility of the side effects of infertility, bladder damage, anger, and such.

All other exams have shown no signs of the cancer spreading. They will do a PET Scan next week to verify this as well. The doctor wants to do two treatments of chemotherapy to make sure cancer cells have not gone undetected, due to technology restraints. We are tentatively set up to start chemotherapy on Saturday, September 25th. Greg will be admitted to the hospital and undergo inpatient drug treatment for 3-5 days. The reason for the inpatient treatment is to keep him hydrated with an I.V. to counter the effects of bladder damage from the cyclophosphamide. He will suffer side effects of lowered immune system and hair loss from the drugs 7-10 days after treatment. Once his immune system recovers (usually 21 days later) he will undergo the second round of chemotherapy. He should be verified cancer-free again within a few months.