Right Time, Right Place

Maintenance treatment keeps follicular lymphoma dormant.

Photo by Jordan Pysz.

Catherine is once again living an active and healthy lifestyle.

Rising up from a small island just off the mainland in the Persian Gulf, Abu Dhabi has quickly grown into the one of the world’s most modern cities. And for the better part of three years, Catherine Goodell called that desert oasis home.

“I was actually there for two years, seven months and a day, but who’s counting,” Catherine says of her stay in the capital of the United Arab Emirates, where her husband worked as a nuclear engineer.

“It was fun for a while,” Catherine adds. “We enjoyed the adventure and made a ton of friends from all over the world that we never would have met otherwise. But it’s a whole other world, and after living there, I value living in the good old USA so much more.”

An Iowa native, Catherine, 52, has spent most of her life in Nebraska, where she was a stay-at-home mom for ten years before working for a few years for a school district. Following their Abu Dhabi adventure, she and her husband moved to Florida.

Catherine now dabbles in photography, and along with her husband, who is semi-retired, she spends as much time as she can fishing and boating on the lake that borders the couple’s Odessa home.

She also fights cancer. Not in the way that anyone outside of the medical field wants to fight cancer – by donating time to fundraising efforts – but on the front lines, where her own personal battle with the disease has been raging since late last year.

“November 29, 2018 was the day I learned of my diagnosis,” says Catherine, who was told she had stage IV follicular B Cell type non-Hodgkin lymphoma (NHL).

The symptoms most commonly associated with follicular lymphoma are a painless swelling in the neck, armpit or groin; fatigue, fever and night sweats. With the exception of the latter, which she attributed to menopause, Catherine experienced none of those symptoms.

“What I did experience was a lot of hip pain,” she says. “I’d been dealing with that for about ten years and just couldn’t take it anymore, so I went to the doctor. They did an MRI that showed I had arthritis, but it also showed that my lymph nodes were enlarged.”

The results of the MRI prompted Catherine’s doctor to order a CT scan. That scan showed the lymph nodes swelling in the groin, pelvis and abdomen. It was then that she was referred to Mamta T. Choksi, MD, at Florida Cancer Specialists & Research Institute.

Totally Treatable

Dr. Choksi’s first order of business was to obtain a biopsy of one of Catherine’s lymph nodes. That biopsy came back positive for follicular lymphoma. Subsequently, a PET scan showed enlarged lymph nodes within the neck, chest, abdomen and pelvis. Bone marrow was also involved with lymphoma making it stage IV lymphoma.

“There are two different kinds of lymphoma,” Dr. Choksi educates. “One is Hodgkin lymphoma. The other is non-Hodgkin lymphoma, and what Catherine had falls under the category of non-Hodgkin lymphoma.

“It’s called a low-grade lymphoma, but unfortunately, as of today, we still cannot cure it. However, we can treat this kind of lymphoma effectively and there are several treatment options available.”

“When my friends found out I had cancer, a lot of them asked why I wasn’t going somewhere else for my treatment. I told them it was because I felt like Florida Cancer Specialists was the right place to be.” – Catherine

Follicular lymphoma is typically treated with either a single form of chemotherapy or a combination of different chemotherapy treatments. The latter is the approach Dr. Choksi initially took to treat Catherine’s lymphoma.

“I initiated her treatment in early January 2019 with a combination of the chemotherapy drugs bendamustine and rituximab,” Dr. Choksi says. “We also gave her a medication called allopurinol to prevent any damage to the kidneys.

“Now there have been a few reported cases where the combination of the allopurinol and the bendamustine has caused a skin reaction as a side effect. After Catherine had a full cycle of chemotherapy, she developed skin rashes.

“We thought the skin rashes might have been due to the combination we were using, so at that point, we decided not to continue that combination and changed the chemotherapy to R-CHOP.

R-CHOP is a combination of five medicines, including rituximab. Because follicular lymphoma cannot be cured, the goal in treating a patient with R-CHOP is to keep the lymphoma dormant for many years.

Dr. Choksi prescribed five cycles of R-CHOP for Catherine. Each was administered intravenously through a port, and Catherine admits that the chemotherapy treatments “took quite a physical toll” on her body.

Clear of Disease

She lost 18 pounds and all of her hair, but she considers that a small price to have paid, because she is now clear of the disease, according to Dr. Choksi, who has since placed Catherine on a maintenance phase that calls for her to receive a shot of rituximab every other month for 24 months.

“Catherine has had a very good response to the treatment,” Dr. Choksi confirms. “In November 2019 she had her most recent scan, the fourth since beginning the maintenance phase in November, and she is not showing any signs of a recurrence of the lymphoma.”

Catherine receives her maintenance injection of rituximab in the belly. She says it takes about five minutes to complete the injection during a visit that lasts about half an hour, but the results have her feeling normal again.

“My hair is growing back, and I feel good and healthy,” Catherine says. “I’m slowly gaining back the weight I lost during my chemotherapy treatments, I feel strong and I can’t thank Dr. Choksi and the folks at Florida Cancer Specialists enough for what they’ve done for me.

“When Dr. Choksi first told me of my diagnosis, she was very, very positive and easy to talk to. I actually felt very comforted by her because she spent a lot of time with me and my husband and answered all of our questions. And we had a lot of them.

“She and her assistants are so warm; they even gave me hugs. Dr. Choksi made it clear that she’s part of a team of oncologists that all talk about what the treatment should be, so I knew I had a whole team working for me there.

“Everyone at Florida Cancer Specialists is so amazing. They’re very patient, very kind and very knowledgeable. Watching them work with other patients, it makes you feel good because you know you’re being taken care of and treated well, and they took great care of me.

“When my friends found out I had cancer, a lot of them asked why I wasn’t going somewhere else for my treatment. I told them it was because I felt like Florida Cancer Specialists was the right place to be.”

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