We had a meeting with the consultant yesterday to discuss why he wants to change J from the ABVD regime to the escalated BEACOPP. Basically it all boils down to them never have used it in our region before and they've decided they'll give it a go with a group of the advanced patients including J.
The plus points are that it can give patients in J's shoes a 10% better outcome. So instead of a 50% chance of getting to 5 years without relapse he would have 60%.
The pay off is greater risk of infection and a greater risk of subsequent cancers.
He has left the choice squarely up to J.
If it were me I would stick with ABVD. Reasons being:-
1. ABVD is easier regime - 2 visits a month versus 4 visits every 3 weeks.
2. He knows he can cope with ABVD. Much more likely to be v ill with BEACOPP
3. He is responding to ABVD. Bloods already better and leg twitching stopped. It IS working.
4. His bloods have never been that bad. I actually think he is in the favourable advanced category rather than the unfavourable advanced. This has never been spelt out. But I have found the International Prognostic Index and I think from the blood results I've seen he might be in the favourable category. And if so his chances are higher and therefore the risk might not be worth it.
5. What happens if he does relapse? If you've had ABVD you still have somewhere to go. I don't know about BEACOPP? (I wish we'd asked that question and we didn't...)
So that's what I'd do. I'd certainly be making sure about the favourable/unfavourable thing. But I'm not him. He is of course, going to go with the BEACOPP....
