I understand the fear, anxiety, and uncertainty that you feel when your doctor tells you or a loved one that you have cancer. At the same time, when your doctor tells you about a treatment called “R-CHOP,” you probably have a lot of questions coming to your mind, such as, “What is it? What does it do?” Don’t worry. Today, we’ll talk about what R-CHOP is, what it does, and how to deal with it in a very simple way that you can understand.
Simply put, what is R-CHOP?
R-CHOP is a combination of five drugs that kill cancer cells . It is a very effective treatment for a type of cancer called non-Hodgkin lymphoma . Each letter in the name refers to a drug used in this treatment.
| Letter | The medicine and its action |
|---|---|
| R | Rituximab: This is a targeted therapy. Specifically, this drug attaches to a special protein on the surface of cancer cells. This allows our body's immune system to easily recognize and destroy these cancer cells. |
| C | Cyclophosphamide: This is a chemotherapy drug. Chemotherapy drugs work by destroying rapidly dividing cells, such as cancer cells. |
| H | Doxorubicin hydrochloride (Hydroxydaunomycin): This is also a chemotherapy drug. |
| O | Vincristine sulfate (Oncovin): This is another chemotherapy drug. |
| P | Prednisone: This is a type of steroid (corticosteroid). It also kills cancer cells. It also helps reduce allergic reactions that can occur with other R-CHOP medications. |
As you can see, this involves chemotherapy drugs as well as an immune -targeting drug (Rituximab). That's why doctors sometimes call this treatment "immuno-chemotherapy."
What types of cancer is R-CHOP treatment used for?
This treatment is mainly given for a type of cancer called non-Hodgkin lymphoma . It is also very effective for the most common type, diffuse large B-cell lymphoma (DLBCL) . In addition, R-CHOP is also used for the following types of cancer :
- Advanced follicular lymphoma
- Mantle cell lymphoma
- Waldenstrom macroglobulinemia
In some cases, your doctor may decide to give R-CHOP along with treatments for other types of cancer.
How does the treatment work?
R-CHOP treatment is given in “cycles.” Each cycle usually lasts three weeks (21 days). There are two parts to this cycle:
1. Treatment days: The days you are given medication.
2. Rest days: Days to allow your body to heal and recover before the next round.
Treatment days
The medication may be given over a period of five days. Prednisone (the steroid ) is a pill that you swallow. The other four medications are given as a saline solution into a vein (intravenous infusion – IV). This will require you to go to a hospital or clinic. There you will sit in a chair while a machine slowly injects the medication into a vein in your body. This vein may be in your arm, hand, or chest. If the treatment is given through the chest, a small device called a `port-a-cath` (chemo port) may be implanted under the skin.
On the first day of treatment, you will be given medicine to prevent nausea. You will also be given medicine to prevent allergies. RituximabIt's normal to feel a little dizzy and warm when the medicine is given. That's why this medicine is given very cautiously at first. But there's nothing to worry about, as you'll be given the necessary medication beforehand to prevent serious allergies.
Rest days
In a typical cycle, you will have about 16 days of rest after the treatment. The body feels very tired as the R-CHOP treatment destroys cancer cells. So it is very normal to feel very tired during these days. During this time, it is very good to ask family and friends for help with daily tasks.
During these rest days, if you are feeling up to it, the doctor recommends doing some light exercise, such as walking. It is also very important to drink plenty of water and eat nutritious foods .
What are the risks and side effects of this treatment?
Like any treatment, R-CHOP can cause side effects. But remember, your doctor will give you the medications you need to prevent or manage many of these side effects. Not everyone gets all of these side effects. It varies from person to person. Let's look at some of the most common side effects.
| Common side effects | What to know and what to do |
|---|---|
| Red/pink urine | Doxorubicin is red in color. Your urine may be red/pink for up to 48 hours after treatment. This is normal, don't worry. |
| Nausea and vomiting | Even if you take medication for nausea, you may still feel a little nauseous. Instead of eating large, fatty, spicy meals, eat small, frequent meals. |
| Hair loss | This is common with chemotherapy. Hair loss can begin within three weeks of the first dose. However, hair grows back after treatment is over. |
| Chills and fever | Chemotherapy can lower your white blood cell count, which increases your risk of infection. You will be given a shot called G-CSF, which helps your white blood cells grow. However, if you develop a fever, tell your doctor right away. |
| Extreme fatigue (Fatigue) | Treatment can cause a decrease in red blood cells, causing anemia. If you feel tired, rest. Ask for help with daily tasks. |
| Easy bruising/bleeding | This condition can occur due to a decrease in platelets. Be careful not to get injured. Tell your doctor if you notice a lot of bruising on your body. |
| Numbness/tingling in the limbs | This is called peripheral neuropathy. If you feel tingling or burning in your hands or feet, tell your doctor. |
Remember, a fever can be a sign of a serious infection. If your fever is over 100.4°F (38°C), call your doctor or hospital right away.
In addition to these, you may also experience mouth sores, skin rashes, headaches, constipation or diarrhea, chest pain, insomnia, and mood changes. Talk to your doctor about any of these.
When should I call the doctor?
Tell your doctor immediately if you develop any new symptoms or if any of your symptoms get worse during treatment, especially if you develop a fever.
In case of an emergency such as difficulty breathing or sudden chest pain, go to the nearest hospital's Emergency Department (ETU) immediately.
How can I make this treatment period easier for me?
This battle is not one you have to fight alone. There are a few things you can do to make this time easier.
- Be informed: Talk to your doctor about your treatment and what you can expect. Don't be afraid to ask questions.
- Ask for help: Ask for help from family and friends with household chores, preparing meals, and going to the hospital.
- Eat and drink well: Eat nutritious foods. Drink plenty of water and fluids.
- Get support: Ask your doctor about support groups where others who are going through the same treatment as you are facing cancer. It's a great strength to have someone to share your experiences with.
The first few weeks of R-CHOP treatment can be a difficult time. The days of medication can be long and the side effects can be difficult to deal with. But for many people, the results of R-CHOP are more than worth the effort. The combination of these three drugs (targeted, chemo, and steroids) works to kill cancer cells very effectively. Depending on your diagnosis, this can lead to a complete remission of the cancer.
Take-Home Message
- R-CHOP is a highly effective combination of 5 drugs used to treat cancers such as non-Hodgkin lymphoma.
- Treatment is given in “cycles.” During this time, it is common to experience side effects such as fatigue, nausea, and hair loss.
- Many side effects can be managed. Always talk to your medical team about them.
- If you develop a fever during treatment, consider it an emergency and seek medical advice immediately.
- You don't have to go through this journey alone. Get support from family, friends, and your medical team. You are strong. You can do this.
R-CHOP, cancer, Non-Hodgkin lymphoma, chemotherapy, targeted therapy, cancer treatment, side effects
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