Monthly Archives: October 2011

UCLA documentary

Below is a link to a short video about the team of doctors who run the Lymphoma Center at UCLA.

Dr. Pinter Brown is my oncologist.

I have also been seen by Dr. Eredat, Grace Cherry and others.

I walk these hallways all the time. I sit in those chairs. I have been the person in the room more times than I can count.

I am extremely grateful that this video was produced and I have a way of sharing some of my experience with all of you. Also, it gives a lot of insight into how UCLA treats lymphoma and how the entire process works.

http://vimeo.com/30452014

Be well.

Patient’s patience

I had another dose of SGN-35 (Adcetris) last week and I’m going to have another PET scan end of next week (or thereabouts).

I decided to not go through with an immediate biopsy because the chance of getting a useable sample was very low and I felt the risk and discomfort was too high. The biopsy would have resulted in:

  • Positive sample = more treatment
  • Negative sample = we still couldn’t be sure that the sample is truly negative because of the small sample size so it would still be inconclusive
  • Inconclusive sample = Inconclusive

With this in mind, my current course of action is to get another PET scan and see if the hotspots go away, stay the same or grow.

If my PET is clear, then it is onto my allo transplant.

Anything else and I’ll either definitely need to get a biopsy or I’ll have to get more chemo treatment to put me into complete remission.

The goal is still the same – allogeneic stem cell transplant.

But we now understand that going into the transplant as close to complete remission as possible is the best course of action. Even if it means more treatment. Even if it stresses us out.

The good news is that there still seem to be a number of chemotherapy treatment options to get me into remission.

One of the most promising options is a study being done at Baylor by Dr. Bollard. If my tumor shows signs of EBV (which is related to the T-cells and found in 50% of Hodgkin’s) then I might qualify for this treatment. We are getting blood and tumor samples tested now.

http://www.texaschildrens.org/carecenters/Cancer/perspectives/archives/spring06/Bollard.html

On a side note: I spent a few minutes this morning reading Hodgkin’s support group forums. I haven’t spent any time in the past looking at these websites as I know they are mostly filled with sad stories and people looking for comfort. Too many questions, not enough answers and too emotionally taxing for me. Jen takes on most/all of the research on herself – which means she also takes on the emotional burden of being aware of other people’s experiences.

However, after reading a few posts, I became even more inspired to keep fighting and develop a new plan – if I need one. Eat healthy. Stay active. Push for the most demanding treatments possible to knock this thing down so I can get into my allo transplant.

“History is written by the victors.” – attributed to Winston Churchill

Or, to put it another way:

Don’t let the highs get too high. Don’t let the lows get too low.

This is the advice I keep giving my friends and family.

If every piece of good news caused me to cry with joy…and if every piece of bad news caused me to cry with grief – I wouldn’t be able to cope as well as I do.

Exhibit A: This week, I was scheduled to get a Groshon catheter placed in my chest on Monday and then be admitted to the hospital on Tuesday. However, looming over all of this was my PET scan results from a week ago.

The scan showed some kind of small, vague PET activity in my chest. My oncologist ordered a CT scan the next day so the UCLA oncology team could take a closer look and see if this was something to be concerned about. They held their weekly meeting Monday morning and decided to review all of my PET/CT scans from this past summer in order to make a determination of whether to a) proceed with stem cell treatment or b) order a biopsy to try to figure out what these hotspots might be.

All of this adds up to no catheter and no treatment for me today.

Yes, this process is full of frustration and worry and anxiety and “two steps forward/one step back”. City of Hope believes that I should go into transplant immediately, regardless of the small activity. But UCLA wants to make sure I am in as complete remission as possible before beginning the process.

So what are my options?

Do I obstruct UCLA’s attempt to be thorough? Do I cry and worry and shut down? Do I continue to put one foot in front of the other, take a deep breath and practice patience? Do I turn to City of Hope and undergo my treatment there?

I was once told I have cancer. But, it was the “good kind” of cancer. Then I was told that the 80% effective treatment didn’t work for me. Then I was in remission. Then not. I suffered through 3 weeks trapped in a hospital room. I’ve had the chills so bad I thought my teeth would shatter. I’ve been poked and prodded, injected, poisoned, irradiated, hugged, cried over, prayed for, supported and insulted, knocked out, knocked down and picked up. I was present when two of my dearest friends got married to each other. And I was in the hospital when another two of my dearest friends got married. I’ve looked in the mirror and not recognized myself. I’ve apologized to my wife many times for being sick. I had a nervous breakdown. I’m pulling a 4.0 in grad school. I’ve laid my best friend to rest. I’ve held my friends’ newborn babies. I experienced loving kindness from a group of strangers like I never believed existed. Yesterday, a nurse gave me a hug and I cried.

What is the appropriate reaction when you are told that the life threatening procedure that might be your last chance at survival has been postponed?

For me – I went out to a lovely steak dinner with my wife and brother.

In all this, my brother donated his stem cells on Monday morning and filled up the bag in one session. Whenever I’m approved for the treatment, his stem cells are tagged, bagged and ready to go. One step forward.

He deserves a special shout-out. He handled the tests, physical, shots and pheresis procedure like a champion and I’m extremely grateful for his dedication, patience and perseverance. For a guy who is a bit scared of needles (and who isn’t?), he sure didn’t act like it. He never complained once. He took time away from his family and work to travel half-way around the world, eat hamburgers, watch some American TV and – oh yeah – give me the cells I need to stay alive. If anyone finds a Hallmark card for that, please let me know, because I don’t have the words.

My lifesaver

And a great dad

 

 

 

 

 

 

 

Any medical procedure – even a voluntary stem cell donation – causes a person to reflect upon their own mortality in some way. I hope he goes away from this experience appreciating the fragility of life a little more. And I hope he feels proud of what he’s done for me. It has been a joy to have him visit, to see his family every morning on Skype and to get to know my brother a little bit better.

For now, I’m off the SGN-35 and I’ll let you know as soon as I know what’s going on with me. This should just be a minor hiccup in the process of getting through an allogeneic stem cell treatment. But we shall see.