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What is Next in the Treatment Plan?

Todd W Franzen

April 15, 2020

What is next now that I have gotten the news of my PET Scan?

Night sky with aurora borealis and text "what is next with treatment?"
What is next with treatment?

Having gone through a similar situation 10 years ago gives me a little foresight into what to expect in the near future. Treatments and Technology have gotten better since I was originally diagnosed in 2009. Discussions and conversations have helped to ease my mind by knowing that my body may not get so ravaged from the treatment moving forward. But it doesn’t mean that the fear and anxiety is any less. 

So at this point, here are five things I’m thinking about when it comes to what is next with the future course of action.  

Need to get a biopsy 

The main reason we need to get a biopsy is to make sure that the lymphoma hasn’t changed or morphed into something else.  This is an important next step because we don’t want to see a change in the lymphoma. It will change how the treatment moving forward is seen and applied. Even though the likelihood is small, the team needs to make sure that there is no change in the lymphoma. 

I ended up getting a call yesterday from the Sonnenalp Breast Cancer clinic at the Shaw Cancer Center in Edwards. They asked me to come over to do a little ultrasound to see what access might be like. When I arrived, I was told me that we were going to do a biopsy at the same time. This took me a little off guard. I wasn’t prepared for doing a biopsy and I drove over by myself. Fortunately, this was all done under local anesthesia (novocaine) and was a little uncomfortable at best. 

Fortunately, I was okay with getting the procedure done in order to help facilitate the time. This also kept me from feeling anticipation and anxiety about a procedure that I knew had to be done.

Treatment Assessment

Once the biopsy pathology comes back, we will have definitive results if it’s the same lymphoma and also how we are going to treat the lymphoma moving forward. Since July of 2019, I have found out I’m allergic to targeted chemotherapy (Brentuximab) And been through 23 sessions of radiation. I was originally diagnosed in 2009, so you can add an extra 15 rounds of chemotherapy along with an autologous stem cell transplant. When you see the entire treatment regimen on a timeline, it shows what is worked, what hasn’t and how much.

That’s why the biopsy is so important. It shows what’s going to be next in the line of treatment. I’m not sure why my oncologist doesn’t go back to a treatment that has worked in the past. I will get that sorted out for another post in the future. 

Start Treatment

I’m not 100% sure what is next with the treatment or what it is going to consist of, but past discussions have talked about immunotherapy. I will know more of what that consists of in the next week or so.

I need to do some research because I’ve heard a number of different ways to take immunotherapy, either being infusion or pill form. Whichever way it is administered, this will officially start the next course of treatment.  

Treatment will consist of about three to four months. From what I’ve Been Told, immunotherapy is much easier and less toxic than regular chemotherapy. I feel good knowing that the general consensus of side effects is much more tolerable than normal chemotherapy or radiation.  

PET Scan @ 3-4 Months

After we do the course of treatment, the next step is to do another PET scan. This will help determine if there is a response to the lymphoma and if there is growth or reduction. So, this is another case of hurry up and wait. Or what I like to call Time or Information Limbo. There’s only one way to know and unfortunately, you have to let time sort out if the treatment worked or not. 

Pet scans are always tough because of the time it takes and how definitive the results are. Each time a scan comes up, anxiety and fear start to creep in. In fact, I call the anxiety, scanxiety because it proves if your cancer is back or you’re cancer-free. 

Scanxiety has been a big part of my time. Key PET scans have shown a reoccurrence each time in my history. And the worst part about it is they don’t get any easier. This past one was my 9th PET scan spanning 11 years. 

Long Term

So, what is next with the long-term look or expectations at this point? I’m going to simplify my mindset and how I deal with moving forward. It’s important that I concentrate on the day and task at hand and not lose myself in what I feel the future can be like. to speculate on an outcome is dreaming. There is no way to be able to predict how this is going to unfold. I can hope that this next course of treatment is going to work. I can continue to feed my body with great nutrition and live an organic lifestyle.

But the reality is lymphoma is a Fickle bitch!

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Todd W Franzen


I am a two-time Hodgkin's lymphoma survivor with 17 years of documented cancer survivorship experience that spans multiple treatment eras. My journey began in November 2009 with a Stage 4B diagnosis at age 33, and continued through recurrence and treatment in 2019-2021. This rare longitudinal perspective—living through two complete treatment cycles a decade apart—gives me comparative insight into cancer care evolution that no single medical professional can replicate.

MY TREATMENT EXPERIENCE

First Treatment Cycle (2009-2010)
• 12 infusions of ABVD Chemotherapy over 6 months
• 2 infusions of ICE Chemotherapy (4-day infusions)
• 1 infusion of BEAM Chemotherapy
• 1 Autologous Stem-Cell Transplant
• 8 PET Scans
• 6 CT Scans

Second Treatment Cycle (2019-2021)
• 2 infusions of Brentuximab and Bendamustine
(Severe allergic reaction to Brentuximab — hives)
• 25 rounds of Radiation to Mediastinum (46RAD combined)
• 4 infusions of Keytruda Immunotherapy
• 2 infusions of IGEV Chemotherapy (5-day infusions)
• 1 Total Body Radiation (2RAD)
• 1 Sibling Allogeneic Stem-Cell Transplant
• 6 PET Scans
• 6 CT Scans

COMPARATIVE EXPERTISE

Surviving two stem-cell transplants—one autologous, one sibling allogeneic—across different decades of cancer treatment has given me firsthand experience with nearly every major modality in lymphoma care: combination chemotherapy, salvage chemotherapy, immunotherapy, radiation protocols, and both types of stem-cell transplantation. I've experienced treatment side effects from the "standard" ABVD era through the modern immunotherapy period.

This comparative expertise matters for survivors. Treatment protocols in 2009 looked very different from 2019, and the long-term survivorship implications are still emerging. Doctors treat; survivors live with the aftermath. I've done both—twice.

CREDENTIALS & PROJECTS

• Founder: Strap In For Life 501(c)(3) nonprofit
• Author: Internal Architect: A Cancer Survivor's Memoir
• Licensed Insurance Agent (practical healthcare system navigation)
• 17-year cancer survivor documenting the journey since 2008

WHAT I WRITE ABOUT

Cancer survivorship doesn't end when treatment stops—it's when the real reconstruction begins. My blog covers:
• Practical survivorship (relationships, careers, identity)
• Treatment experience insights (what they don't tell you)
• Long-term effects and secondary health considerations
• Mental health and emotional reconstruction
• Healthcare system navigation

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