What are the common side effects of the first line treatments for newly diagnosed DLBCL patients, and how are they managed?
Chemotherapy is chemotherapy. It's annoying, but it's not quite as much as people picture it that they are just going to be, you know, lying in bed for weeks at a time. Again, people getting these common chemotherapies like the R-CHOP, R-CHOP, we would like them to be living their lives, but it won't be totally normal. Again, I have patients who are working full time and during R-CHOP, they will still be working, but they're usually working part time because the kind of the calendar of most of these chemotherapies is you get one dose and then three weeks later you get the next dose, and maybe you do that six times. That's about 4 or 5 months right there.
And, you know, during these three week intervals, it's kind of a little bit of a roller coaster feeling, maybe a little tired the first day and then not too bad. And then really about a week or two later, maybe on day ten out of 21 days, people are feeling their worst, more tired. People are feeling their worst, more tired. Sometimes they'll have mouth sores. They're still eating and drinking, but the food doesn't taste as good. And the biggest thing is that their immune systems are low, especially they're in the middle of every 21 day cycle. And when their immune system is low, they may not feel the difference, but they're at risk for serious infections.
So, you know, the patients may think, oh, I have to be in a bubble. No, you most will live your life, but you avoid, you know, crowded places, subway, crowded restaurants, anything like that. And you avoid people who you know are sick. And if you have grandkids that are visiting, they're not allowed to come over if they have a cold, which most grandkids do. So yeah, it does affect your life, but you're still living your life, but it is a little slower and those are probably the biggest side effects that people feel.
The tired, even though we don't feel, the risk for infections when the immune system is low, sometimes people feel those mouth sores or other discomfort when eating. And one other side effect, it's not usually too bad, is people get a numbness or tingling in the fingers or the toes, which is from one of the chemotherapies. It's annoying, but not usually too bad. But your doctor needs to hear about how that's going because a little numbness tingling? Not too bad. But if people are having pain, doctor needs to know about that because they have to change the therapy a little bit.
And then again, the side effect I mentioned, which is not the end of the world, but it is super scary for patients, is patients lose their hair. Not right away when the treatment starts. But, you know, two, four weeks later they start to lose their hair. Everyone's a little different. People that already had thinning hair—yeah, they lose their hair a bit more. And it is scary and unpleasant for some folks. It's not so bad because it grows back, you know, in almost every single patient. It grows back pretty well.
HealthTree • March 6, 2026