ABVD for Newbies – Part One

ABVD for Newbies Chapter One: Scared witless?  We all are.

OK.  So we’ve established you have Hodgkin’s Disease and you have to get chemotherapy.  I’m very sorry and I say that with the deepest sincerity. (I’m probably the twentieth person to tell you that and I’m sorry for that too!)  I have been through what you are about to go through and frankly I wouldn’t wish it on my very worst enemy in the entire world.

That said, what you’re about to go through is something literally thousands of people have been through.  We made it through ABVD and so will you!  THIS IS DOABLE.  THIS IS NOT THE END OF THE WORLD.  YOU CAN, AND WILL, BE OK! There is absolutely no reason to think otherwise. You can, and you will, win.

First, let’s go over a little bit about what ABVD is.  You can get much more information from your oncologist, but a little knowledge can help you discuss things a little more intelligently with your doctors and nurses and ask better questions.

ABVD is a four drug regimen. Someone once told me a joke that ABVD sounds like a sexually transmitted disease that honor students get. Get it? AB-VD? OK, maybe not the best joke. Anyway, the drugs are Adriamycin, Bleomycin, Vinblastine, and Dacarbazine. Yeah, the creators of ABVD weren’t exactly creative when they came up with the name. 

The drugs are usually given in that order (A, B, V, D).  An ABVD cycle last 28 days and consists of two treatments given two weeks apart. I know! No one told me there were TWO chemo treatments in each cycle — I think that is total false advertising.  Anyway, after the second treatment, the cycle starts anew.  Therefore, if you are slated for six cycles of ABVD, you will be treated twelve times over about six months, with treatment say every other Friday.

Each of the four drugs work against the Hodge a little bit differently, and each has it’s own side effects.  They are given in very precise doses and at precise intervals.  They are designed to work in combination with each other.  ABVD is an old regimen — around since the 70s (it is probably older than you are…. it is older than me!) — and your medical team know exactly how much of each drug you need to get to hopefully cure you.  This isn’t an experimental treatment. ABVD has a very good track record of getting people into remission. (However, if you’re like me and your stage III/IV, you may want to ask your oncologist about other options available like BEACOPP because some studies show it is superior to ABVD for us advanced stagers.)

OK, now you know a little bit about ABVD, let’s now address fear.  Every single one of us who has been through this has felt the same dread you’re feeling.  We all may try and cope differently — for example I joked much more than usual — but no one wants to go through chemotherapy.  It’s a big unknown and it’s something depicted in popular media, film, and literature as terrifying.  When someone said chemo to me, I would picture in my mind this image of a completely hairless, lifeless, wasted away person with their head in a toilet throwing up non-stop.

Here is the good news — like I pointed out earlier, that’s not what ABVD is like! Or at least it wasn’t that way for anyone I’ve ever talked with about it.  I can also say CHOP-R (Non-Hodgkin’s lymphoma’s chemotherapy regimen) also isn’t like that.  (I know because my dad had N-HL two years before I was diagnosed with Hodgkin’s Disease.)  ABVD is basically a moderate chemotherapy course – the worst thing about ABVD is how long a therapy course it is.

So what can you expect from ABVD?

The one thing I am going to promise you is I’ll be honest. I’m not going to sugar-coat stuff or tell you everything is going to be awesome. That’s not fair to you. But I’m also not going to scare you. I’m just going to try and be honest.

Hair loss. You probably will lose your hair. (Probably around the second or third cycle.) Sorry. =( This is one side effect they haven’t made much progress on alleviating. HOWEVER, not everyone loses their hair, so you may want to wait and see before you make any drastic decisions. My hair thinned considerably, but I still had enough at the end to tie back into a ponytail and I did the maximum amount of ABVD at eight cycles.

I would be prepared for hair loss with a wig, scarf, etc, but I wouldn’t shave my head as a preemptive strike just in case your lucky. Your stylist may be a good source.

Some nausea. You will probably be nauseated, at least sometimes and at least a little.  People have differing amounts, however. I seemed to get more than my fair share of nausea, but I never actually threw up. I think I had more nausea because I suffer from GERD anyway. (We’ve established how lucky I am. haha.) There are MANY excellent anti-nausea medications out there — they may not prevent every twinge, but if used properly you should DEFINITELY not be spending your days throwing up. I think I only actually threw up once and I was nauseated a lot.

Fatigue. You will be tired. However, although ABVD causes fatigue, MANY people are able to work at least part-time through it, some even full-time. It really varies from person to person. I ran and worked part-time and traveled through my 8-month course.

Feeling bleh. For want of a better term, you are going to feel bleh sometimes. It is hard to describe. Kind of like how you feel when you have a stomach flu, I guess.

Those are the big side effects of ABVD.

All right, so that’s a little introduction to ABVD.  I hope you aren’t quite so scared now.  Part two of this article explains what to expect on chemo day.

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