What is a "round"?

[Wes Turner]

My wife has lung cancer. We are having an argument about what is a "treatment" vs a "round" vs something else.

She started treatment back in February. The plan was three infusions of chemotherapy each 3 weeks apart. I thought those three treatments or infusions were called a "round". She thinks each infusion is a round. Who is right?

She just started the first of 4 more infusions, again each 3 weeks apart. Was what she had today the first treatment or infusion of her second round of chemo or the 4th round. And if the latter, what is the group of infusions called?

Thanks,

-wt

 

[Wes Turner]

After a little more research, I see that the terms "cycle" and "course" are used, but I am still not clear on what each term means. One website seemed to indicate that each "treatment" (infusion) is a "cycle: and a series of cycles is a "course". This seems odd to me.

Another website seemed to indicate that each infusion was a "treatment", a series of treatment is a "cycle", and a series of cycles is a "course".

My wife had 3 infusions at 3-week intervals using two chemicals (Cisplaten + Alimpta) followed by a PET scan. Based on the results, she just started the first of 4 more infusions at 3-week intervals using just the Alimpta. That will be followed by another PET scan and then a decision will be made as to what to do next.

Can someone clarify the terminology?

Thanks.

-wt

[DFK]

Hi Wes,

I've spent 30 years in the health field and terminology has changed and been substituted for the same darn thing. It depends on where you work and what the climate is in whatever department you may work in. I've worked on the East Coast and West Coast in ICU, CCU and ER and never ceased to amaze me how I had to ask for clarification on what was being said and what was being ordered by the Physicians, so don't feel lost.
 

So here's my take:

Treatment usually refers in general to your "Plan of Care". This entails everything that has been coordinated and ordered to get you to  "their" goal. Your treatment may include chemo, radiation, Durvalumab and symptom management etc. Your treatments will change according to your needs. 

Cycle or Course are interchangeable and usually refers to your wife’s infusions. Cycle refers to one sitting (course) of whatever chemotherapy has been ordered. In your wife's case, the Cisplatin and Alimta. So you may have heard she will have three cycles of Cisplatin and Alimta three weeks apart. Or you may have heard she will have three courses of Cisplatin and Alimta three weeks apart. 
 

Your best bet is to do like I did and ask for clarification if you don't quite understand what your wife"s treatment plan entails.

As you know, there are standards of care for every diagnosis and most Cancer Centers refer to the NCCN standards of care and practice. www.nccn.org    ( National Cancer Center Network) Those are guidelines to be followed but not necessarily always adhered to. If I felt my Oncologist was way off base on following some of the guidelines, I asked him why and he always had sound reasoning behind his decisions. It's important to have a comfortable and trusting relationship with your Oncologist. Mine rarely uttered a word but when queried about any concerns I may have had, he was extremely pragmatic with a sound and justifiable explanation. 

Good Luck Brian

Come join us on the Durvalumab forum.

Take Care, Blessings, DFK

 

[Wes Turner]

OK, good information. So she had 3 cycles or courses in Jan-Feb and just had the first of 4 more today. The first three were one step in a treatment plan. Is there an accepted term for those 3 courses? I have been using the term "round", but my wife thinks a round is each infusion.

I didn't think to ask the oncologist today and now it's the weekend, so I can't ask until Monday. But I want to send out a status update to family members and we are stuck on the terminology.

I'd appreciate any help.

What's the correct term for several cycles or courses that are ordered as a single step in the treatment plan?

Thanks

[DFK]

I really don't know the correct term Wes, but I think it would be fair to update your family with exactly what has transpired and what you had said in your previous posting, "She had three cycles (Infusions) of chemotherapy in Jan-Feb followed by a PETSCAN. Based on results of the Pet Scan, the doctors ordered another 4 cycles of chemotherapy. The PETSCAN showed______________________________, therefore, the added chemotherapy is to ______________________________________. We are quickly learning that her cancer care is fluid and may change according to her responses to the chemotherapy"

Start there????? 

Good Luck

Take Care, Blessings, DFK

[MyWifeSCLC]

Hi Wes ... your post was very interesting and I thought I might give my "2 cents worth". I'll use my wife's treatment as an example based on my understanding which could be wrong.

Her first-line chemo treatment is 4 to 6 cycles every 21 days of 3 rounds each of Cisplatin and Etoposide. Her treatment is the entirety of what's going to happen to get her cancer under control for the first time. A chemo cycle is what occurs every 21 days which is 3 straight days of chemo. A round is a single day of the chemo IV so each cycle is composed of 3 days/rounds of chemo.

I haven't heard the term course yet from the doctors and nurses and will probably ask someone today when I take my wife in for radiation.

I hope everything goes well for your wife.

Steve