Friday, November 9, 2007

Anna, Mom and me in Sudbury

Anna, Mom and I were in Sudbury today for a consultation with Dr. Herst. Here's what we know: The results from the CT scan may indicate a swollen lymph node in my right axilla in addition to the two in my neck. If this is confirmed on the gallium scan, then it likely means I have at least Stage II lymphoma. Could be higher yet. We're still waiting for the radiologist's report on the gallium scan. And the bone marrow biopsy results will be at least another three weeks to come in. Also, one of my blood tests showed that my immunoglobulin levels are slightly elevated. This MAY indicate that I have an indolent follicular lymphoma which has transformed to a diffuse large B-cell lymphoma. What's the difference, I ask? Indolent lymphomas are common. They are slow growing and often simply monitored. They may never require aggressive treatment. However, some will transform into the more aggressive diffuse large B-cell lymphoma. The diffuse large lymphomas are curable. The indolent lymphomas are not.

The intent of treatment of a diffuse large lymphoma is cure. The intent of treatment of an indolent lymphoma is palliation.

Cancer was more fun when I thought I had a curable disease.

This blood result does not mean for sure that I have an indolent lymphoma transformed to diffuse large B-cell. But it may. Regardless, the treatment is the same. I start chemo on Tuesday, with a full day in Sudbury. They'll give me rituximab, a monoclonal antibody, and watch me closely for side effects. Rituximab sounds really cool, it is a protein that specifically targets tumour cells. This means it has very few systemic side effects. If I tolerate the rituximab well, I'll get the full course of CHOP chemotherapy on Wednesday. CHOP is a cocktail of three drugs given IV (cyclophosphamide, doxyrubicin, and vincristine), as well as one drug given orally (prednisone). Assuming my white blood cell levels remain high enough, I will get CHOPped every third Wednesday for eight cycles, or until mid-March.

I'm kinda bummed right now. Should I hope I have the deadly-but-curable diffuse large lymphoma alone? What is the silver lining if I have an incurable indolent lymphoma?


jodie said...

Bob, don't lose that positive attitude... you will beat this thing! Defeat the odds, do it! As you know you are in my thoughts and prayers. Love to you both!

Jim said...

Hi Bob & Anna! Jim here....
Jodie and I were just talking about you guys and I had a thought that we wanted to share.
You asked where the silver lining is? It is simply you. that you are here, your contribution to our planet, your connections to us and your friends and family.
That kind of thing can and will never end.
Keep smiling and dreaming!

kim said...

Hey Bob and Anna, just read your results from Sudbury, please know that when you have low moments there are so many people pulling for you both, there is a silver lining,you may not always see it, especially when it is cloudy, but it is there. Believe. I will touch base with you both soon. Love, Kim

lisa said...

Bob and Anna.... there are so many thoughts/feelings that overwhelm me when I read your bogs( which is daily!). We love you both!! Our hearts and prayers are with you. But today, as I read your blog, I couldn't stop thinking about my mom, who was diagnosed with indolent lymphoma. She lived with it for over seven years. She had one round of chemo that was too harsh for her body, and was advised never to have the treatment again. (Unlike you, very health and positive, she was ill and had an immune disorder.) The lymphoma did exist in her body, but it never grew and she never had treatment again..... the silver lining, I think it changes day to day, but as long as your positive attitude stays within your heart, so too will your hope and love.
Loads of hugs and kisses,