Hodgkin’s Lymphoma Chemotherapy (ABVD), Abroad

Hodgkin’s Lymphoma Chemotherapy (ABVD) cost:
{the cost covers all destination medical & logistics costs}
International Destinations: India, Jordan, Mexico, South Korea, Turkey

ABVD is the abbreviation for one of the most commonly used chemotherapy regimen for the management of Hodgkin’s Lymphoma. It is used as the first line of treatment which is used across the world for newly diagnosed patients suffering from Hodgkin’s Lymphoma. This chemotherapy regime was developed as an alterative for MOPP chemotherapy regimen (which was extremely effective against advanced cases of Hodgkin’s Lymphomas) but had very high toxicity and resulted in bone marrow suppression. As an alternative, ABVD was developed, which is less toxic and extremely effective in management of early stage Hodgkin’s Lymphoma. Chemotherapy is a long term regime which involves several cycles each lasting for several days. This chemotherapy treatment is available in Jordan, Turkey, India, South Korea and Mexico, at costs fairly lower than those in the United States.

The Drug Regimen for Hodgkin’s Lymphoma (ADVB):

Like most chemotherapy regimens, ADVB chemotherapy treatment typically comprises of four to eight treatment cycles, with each treatment cycle lasting for about four weeks. The regimen comprises of four drugs that are given intravenously on an out-patient basis, not requiring hospitalization. During each treatment cycle, two doses of each of the four drugs are given at fixed intervals of time. (i.e. on the first and the fifteenth day of the cycle). The dose is calculated using a table which estimates the body surface area using simple measures like height and weight of the patient. The drugs are,

• Adriamycin ( Doxorubicin): It is an anthracycline antibiotic, which inhibits the DNA/RNA replication and prevents the cancerous cells from multiplying
• Blenoxane (Bleomycin): It is a glycopeptide antibiotic, which induces breaks in the DNA strands of the rapidly multiplying cancerous cells.
• Velban (Vinblastine): It is an anti-microtubule drug, which inhibits the assembly of microtubules during the cell division phase and restricts the growth of cancerous cells.
• DTIC (Dacarbazine): It is an anti-neoplastic drug, which impedes cellular growth and prevents formation of new cancerous tissue.

The number of cycles for the treatment of Hodgkin’s Lymphoma depends upon the stage of progress of the cancer. Early stage cancers may require only two or three cycles, while about eight cycles may be required for advanced stages of Hodgkin’s lymphoma.

Preparing for ABVD for management of Hodgkin’s Lymphoma:

Basic investigations are essential before the patient is started on to ABVD treatment regimen for management Hodgkin’s Lymphoma.

• Complete blood count is conducted. This is essential to evaluate the impact of the chemotherapy regimen on the blood count, as chemotherapy is known to suppress the white and red blood cell count
• Liver function and Kidney function tests are mandatory.
• Bleomycin is know to have a detrimental effect on the lung functions and hence a X ray chest is mandated prior to the initiation of the chemotherapy treatment
• Doxorubicin tends to have a negative effect on the heart and hence an echocardiogram is critical to evaluate the functioning of the heart

Based on these tests the fitness of the patient to undergo chemotherapy regimen is assessed and the treatment is initiated.

Treatment Outcome of ABVD in the treatment of Hodgkin’s Lymphoma:

Hodgkin’s Lymphoma is highly curable after chemotherapy treatment. Clinical evidence and studies suggest that 92% of the cases remain in complete remission for about two to five years after treatment with ABVD. Occasionally patients may relapse with the cancer and would require higher dosage chemotherapy treatment or peripheral bone stem cell transplant.

Side Effects during ADVD Chemotherapy for Hodgkin’s Lymphoma

Similar to any other chemotherapy regimen, ABVD also develops several side-effects which affect the patient in short and long term.

Short term effects:

• Alopecia or loss of hair is a very common side effect for patients being treated with ABVD chemotherapy treatment. This is a temporary phenomenon and it is reversed after a few months of completion of the treatment.
• Gastrointestinal disturbances like nausea, vomiting, loss of appetite, diarrhea and constipation are common side-effects of the ABVD treatment. During the treatment the patient is prescribed medications to relieve these symptoms.
• Bone marrow suppression can occur in more than 50% of patients being treated with ABVD. This result’s in the fall in the white blood cell count, making the patient prone to infections. Similarly red blood cell counts would also fall, which is presented in the form of tiredness, weakness and a constant feeling of ill health.
• Some patients may develop an allergic reaction to the ABVD drugs and hence these drugs are tested in small quantities before initiating the treatment process.
• Numbness due to neuropathy is a common consequence. The numbness is felt in the tips of the toes and fingers and is usually a temporary side effect of the treatment.

Delayed and long term side effects:

• Infertility: The ABVD chemotherapy regimen is known to result in a fall in the sperm count among males, though the effect on female reproductive system is very rare.
• Effects on the respiratory system: Common symptoms that develop months after the treatment are manifested in the form of shortness of breath and cough. These symptoms are attributed to bleomycin, which causes pulmonary toxicity, affecting about 18% of the patients given ABVD treatment.
• Effects on cardiovascular system: These effects are attributed to the drug adriamycin which causes cardio toxicity. The probability of these complications tends to increase with the increase in the dosage and the number of chemotherapy cycles that the patient is exposed to.
• Secondary cancers: Clinical evidence and studies suggest that patients cured of Hodgkin’s Lymphoma are at risk of developing other cancers. Several studies have suggested that chemotherapy as a whole increases the probability of developing secondary cancers which may manifest in the form of lung cancers and breast cancers.

Hodgkin’s Lymphoma Chemotherapy (ABVD) in India:

India is developing as a strong contender for medical tourism in the South East Asian region. This is in lieu of the medical care quality standards comparable to those of the leading hospitals in the United States. Furthermore, India is the cheapest medical tourism destination in South East Asia with a strong advantage over other destinations like Singapore, Malaysia and Thailand.

Hodgkin’s Lymphoma Chemotherapy (ABVD) in Mexico:

Mexico is ranked 61st in terms of its quality of healthcare infrastructure by the World Health Organization, which takes into account the physical infrastructure, qualification and experience of doctors and the medical teams, and the cost of medical care. Its proximity to the United States makes it more preferred compared to other countries which require a travel time of almost 20 hours.

Hodgkin’s Lymphoma Chemotherapy (ABVD) in Turkey:

Turkey is rated as one of the top notch countries for medical tourists. As a mandatory requirement to join the European Union, government regulations are increasingly enforcing stringent regulations to improve the quality and technical standards of medical care. This is looked upon by many Americans as a guarantee for low cost high quality medical care.

Hodgkin’s Lymphoma Chemotherapy (ABVD) in Jordan:

The Ministry of Health, Turkey, has laid down a detailed action plan to boom the medical tourism market in the country. With an objective of reaching a revenue target of $1 billion annually by 2010, the country is focusing on improving its physical infrastructure and providing healthcare services of high quality.

Hodgkin’s Lymphoma Chemotherapy (ABVD) in South Korea:

Modern Equipment and Technological innovations, top rated highly qualified world class medical teams, unique medical caring and hospitality, and low cost of medical care are some of the features of South Korean Medical tourism market. It is worthwhile to note that South Korea has started focusing on medical tourism just recently but has already been labeled as the plastic surgery capital of the world.

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Medical Tourism Corporation facilitates affordable Hodgkin’s Lymphoma Chemotherapy in world-class oncology treatment destinations.