Back in early July we made a trip up to Duke and met with Dr. Horwitz and his medical team at the Adult Bone Marrow Transplant center. The assessment at that meeting determined that I would be a candidate for what is called an autologus stem cell transplant. A bone marrow transplant and a stem cell transplant are two different terms describing the same process. An autologus transplant uses the patients' own stem cells and an allogenic transplant involves using donor cells. One of the big advantages of an autologus transplant is that the body is much less likely to reject the transplant because the cells being transplanted are it's own. So hearing that I would be able to have an auto transplant was indeed welcome news. We were given a fairly detailed briefing on what a stem cell transplant entails. To say that it is complex and complicated is a gross understatement. Our daughter Jill, who is now a stay at home mom with three children, spent a year as an RN in the Pediatric Bone Marrow Transplant unit at Duke, and has been an invaluable resource to us in understanding what things mean and what is involved. She describes a transplant as "pushing the reset button on your immune system". If only it were that simple.
Most of my posts up until now have dealt with my chemotherapy treatments, with a few digressions into genealogy and visits to the beach with the family. I am bringing up the subject of stem cell transplant because in about 4 more weeks I will be finishing a key check point in my chemotherapy treatment protocol and will have a CT scan, a bone marrow biopsy and blood tests to enable my oncologist, Dr. Beaven, to "restage" of my cancer. Depending on the results of those tests, I will either be scheduled for 14 more weeks (2 cycles) of chemotherapy, or, if we have achieved the hoped for word "remission", I will then be transferred to the BMT center to begin the transplant process. Regardless of whether remission is achieved at the end of 2 cycles, or 4 or 6, I will then undergo a stem cell transplant. The only reason for not getting a transplant would be if the cancer is not responding and is in fact getting worse. But the latter is not even an option for our consideration. Being a stubborn fighter with an iron clad constitution and a strong faith in The Most High God, coupled with the support and prayers of a large group of friends and family, the end result is We're Going To Beat This.
The transplant process will start shortly after the remission determination. While the overall transplant process will be spread over 9 to 12 months, the first 2 months are the most intense and potentially problematic. Within the first couple of weeks I will be admitted to the hospital at Duke for the actual transplant and remain an inpatient for about a week to 10 days. I will then be dismissed but will have to make daily visits to the clinic for checkups and medications. During this time, 6/8 weeks, we will actually be living in an apartment near Duke, to facilitate our frequent visits. After that we will be able to return home but will be frequent visitors in Durham for several months.
The coming transition from chemotherapy to transplant is but one more phase on the emotional roller coaster ride of being a cancer patient, and the wife of a cancer patient, and the son or daughter, or a friend. While on the one hand we are dealing with this fight and all that it entails one day at a time, a certain amount of thought and planning must still be invested in what lies ahead. Chemotherapy was a scary thing before I started getting treatments, but now that I am traveling down that road it is not nearly so worrisome or daunting. Now a stem cell transplant is on the horizon, and with that thought comes fears and worries about the unknown path that lies ahead. But I know that many, many, many other people, just like me, have gone through transplants and are now living cancer free lives as a result. So if they can do it, so can I. And most importantly I know that my God will be with me every step of the way, so I have nothing to fear.
Some might ask why a transplant is required if the chemotherapy treatments have gotten the cancer into remission. A large part of the answer lies with the type of lymphoma that I have. Non-Hodgkin's Peripheral T-Cell Lymphoma NOS (Not Otherwise Specified) is a very aggressive form of the disease that is difficult to get into remission and, once in remission, it has an unacceptably high rate of recurrence. The clinical trial that I am participating in is a research study targeted at improving the rate of achieving remission. Remission really means "no signs" of the cancer, but is not a guarantee that there are not a few stray cancer cells still hiding out somewhere, waiting to cause trouble later. The transplant process involves giving high dose chemotherapy early on, which is far more destructive than regular chemo, and greatly improves the chances that any remaining cancer cells are destroyed. It still is not a guarantee but it does improve the odds of not having a recurrence. Since my form of lymphoma is so rare, only 340 cases last year worldwide, the experience with this specific type is very limited and the treatment protocol is not as refined as it someday will be. So we are simply trying to hedge our bets and go with the combination of treatments that will provide us the best odds in the longer term. My body is still strong, and that coupled with my faith and my team of prayer warriors, will see me through this ordeal.
This post is longer than most, but there is a lot to consider as we look at what is before us in the coming months. It is my hope that, in addition to keeping you up-to-date on my status, this may be helpful to others who may be on the same journey that I am on. This blog website gives me the ability to see where the viewers are from, and I see regular visits internationally, particularly from Russia. If I can somehow be a resource to help someone better cope with their own situation, I will consider that a blessing. That is why I have added a section with links to other blogs and informational websites. And if my faith and my belief in the power of God Almighty can help others learn to lean on Him, I will feel even more blessed.
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