Authored by Brian Stabler of Chapel Hill North Carolina USA.
Brian is a professor and specialist in stress at the University
of North Carolina Medical School, and is an 8 year survivour of Non-Hodgkin's Lymphoma.
Brian successfully under went Rituxan therapy in North Carolina earlier this year of 1998.
Brian wrote this article because he found a gap in the
information cycle related to Rituxan therapy.
Brian is currently woking with cancer patients who are
strugglingling with the stresses of cancer.
For more information on Rituxan, please speak with your doctor or
oncologist. Rituxan is available by prescription only.
(Therapy for low grade B-cell non-Hodgkins lymphoma)
How and why Rituxan works
Low grade non-Hodgkins lymphoma (NHL) cells are not easy to spot by your cancer-fighting
immune system. Rituxan works by attaching a biological "flag", called a
monoclonal antibody, to proteins which are on the surface of the lymphoma cells. This
makes it easier for your immune system to find the lymphoma cells and destroy them.This
process is called biological response therapy or immunotherapy. The treatment acts by
stimulating your body's own abililty to destroy cancer cells instead of relying on more
toxic and less specific drugs. Thus there are different and generally less toxic side
effects than with standard chemotherapy.
Rituxan is administered as an intravenous infusion (IV) once weekly for four weeks. You
may have received chemotherapy or blood transfusions this same way in the past.
Many patients receive a second four week course of Rituxan after a brief "rest"
period.
Rituxan had a complete or partial remission rate of 48% when tested in the early trials.
What you might experience while on treatment
Rituxan may cause the following discomforts : weakness, fatigue, sweating, chills and
shaking (known as "rigors"), headache, breathlessness, racing heart, and muscle
aches. Some people also develop a rash over various parts of their body, but this is not
as typical.
Most patients experience some discomfort while Rituxan is being infused. These symptoms,
although upsetting, are expected and will be managed by your physician and nurse by taking
over-the-counter remedies (Benadryl and Tylenol) just prior to starting treatment to
reduce any discomfort. It is important to remember that being alarmed by these symptoms is
understandable. They need not frighten you since they are part of the response to
treatment and indicate that the treatment is doing it's work. If you have concerns, please
talk with your physician or nurse.
For some patients some of these symptoms can occur a day or two following therapy. All
symptoms need to be reported to your physician who will make the necessary plans to treat
them and reduce discomfort for the following treatment cycles.
Tips to help you with the Rituxan treatments
You will receive four infusions of Rituxan at weekly intervals. Treatment generally take
longer in the first session because the Rituxan is given to you slowly. This allows the
medical staff to observe your reactions and make adjustments as necessary. For the first
session this may take 4 to 5 hours during which time you will be either in a comfortable
reclining chair, or in a bed. One of the medications you will be given (Benadryl) makes
you drowsy and so it is necessary to have someone accompany you for each infusion in order
to drive you home afterwards. All treatment is done on an outpatient basis.
Lying quietly for several hours can be hard for even the best of patients and so planning
for diversions during this time is a good idea. Some people bring along a book or magazine
to read, others a crossword puzzle, many folks like to use a portable audiotape/CD player
with headphones to help them while away the time.
Most centers where you will be treated have soft drinks or snacks available, but you may
prefer to bring along your own favorites. The treatments are likely to go through a lunch
hour and so you may want to check with your doctor or nurse about having a snack.
Bringing your own pillow or cover can also make the experience more comfortable, although
everything you will need is readily available on site.
Because your visits to clinic will be regular you are likely to strike up new
acquaintances during your infusion sessions. Some people use these opportunities to share
their experiences with treatment, and often pick up invaluable new insights of their own.
You may want to use the audiotape relaxation and visualization exercises which accompany
this brochure. These techniques are often useful ways of overcoming boredom and increasing
a sense of wellbeing and optimism.
Finally, remember, if you experience any feelings of discomfort or unusual sensations let
your nurse know immediately so that changes may be made in the infusion process.
Understanding and coping with physical symptoms
Patients report that if they are told ahead of time to expect discomforts, the effect is
not so alarming. This knowledge and information is a vital part of your ability to cope
with the stress of physical discomfort, fatigue, and worry that is a part of cancer
treatment. Of course, remember that everyone has a slightly different experience and not
everyone has the same combination of reactions to treatment.