A few months ago one of the other doctors showed me an X-ray of a young man with a huge mass on this Chest Xray. Any cancer here usually carries a poor prognosis unless it can be surgically removed. With this one being in this guy's chest, I knew surgery was no longer an option. I talked to the patient and his parents about his symptoms of weight loss, shortness of breath, and discussed what was most likely the cause - a cancer of some kind. I explained that we didn't really have the ability to tell what kind of cancer it was, and so we really only had a few choices. They could go to another hospital in the country to try and get a biopsy and know for sure what it was, or we could try to give chemotherapy for the 1 cancer that we have a chance of beating (Lymphoma), or they could do nothing. They talked about it amongst themselves and came back a week later, saying they would like to try the chemotherapy.
Despite being a family practice doctor, I have treated many kinds of cancer through my years, pending on the surgical diagnosis and our chemotherapy options. The regimen that we have had the most success with, is CHOP, for lymphoma. For whatever reason, in our setting, basic CHOP works and seems to give folks a chance to beat the cancer, if it responds. We typically give 1 dose, and see them back in 1 month, if they respond, if the tumor shrinks, we keep going - if it doesn't respond, if the tumor doesn't change, then there is no reason to subject their bodies to the effects of the chemotherapy. I have done this enough to know that not everyone responds, and while I hope and pray that they do, I don't have a way to know if they will, so I hold out hope, but don't hold too tightly too it.
When this patient came back with his family, I reexplained what the plan was, and they agreed they were good to start the treatment, so I took a prechemo X-ray to see where we were starting from, and then I gave him the dose of CHOP that he needed and asked him to come back a month later. I had kind of forgotten about him with Covid hitting, but the other week I was in our clinic and one of our doctors asked me to see his X-ray, and I couldn't believe what I was seeing. I asked him how he was doing and he told me he was great, didn't have any symptoms, he seemed like he was fine. I asked him to get a 2nd X-ray not really believing that 1 course of treatment had seemed to fully resolve his symptoms or the mass in his chest - but the 2nd was no different than the first. It was gone.
This doesn't usually happen this quickly, with just 1 round of chemotherapy, but I am thankful for this guy, who seemed to respond very well to the chemotherapy. I will keep praying for his healing as we continue to finish out our course of chemo.
