Wednesday, July 26, 2017

Medical: Upcoming Procedures & Treatment Alternatives

Bottom Line from today's hip biopsy: hope to have cytology and cytometry results by Friday.  

Recall that I can do no worse than a 9 month, three-phase of treatment:
  1. Ghost of Christmas Past: 3 months of Rituxan-Bendamustine (RB Chemo))
  2. Ghost of Christmas Present: 3 months of RC* Chemo (where C is much more toxic than B)
  3. Ghost of Chistmas Future: Stem Cell Transplant (3 wks hospital, 10wks recovery)

The tests we're doing over the next 2 weeks are to replace 2 & 3 with simultaneous radiation of my neck during Phase 1 (if the cancer has not spread, we assume radiation and target it where it now is, and RB chemo can circulate and find stragglers).  All scenarios assume Phase 1 Chemo, above.

To Replace Phases 2 & 3 with Radiation requires:

A) Clear cytology (humans) and cytometry (laser-sensors) of the marrow extracted today (we already did this for previous needle and surgical biopsies)
B) Clear-beyond-neck PET scan (The best--but expensive--whole body scan for cancer)
C) Clear Colonoscopy and Endoscopy (throat-stomach)

I feel a little like they're moving the goal posts with C, above, but I get it: they want to really really be sure the MCL is Stage 1 and limited to my neck.  If there is any sign of it having spread, they'll want to do scorched-earth treatment (Phase 3) while i"m still young enough to endure it.

Having had my "50" colonoscopy early (at 47) I was due for one next year, so seems worth moving up, particularly since this lymphoma has a tendency to appear in polyps in the colon (and I had 4 pre-cancerous ones last time).  And Endoscopy of throat and stomach seems no biggie either.

The balancing act is between:
  • Doing what's required now to maximize chances it does not re-occur--but not over-treating
  • Envisioning what treatments they've "saved" for if it comes back
  • My current and projected future tolerance for treatment.
  • Knowing that recurrence treatments keep getting better



2 comments:

Anonymous said...

It's helpful that colonscopy and endoscopy can be done at the same time (hope that's your case); endoscopy really is nothing but 10 minutes of reverse-Alien.

busiestday said...

Endoscopy: when your doctor looks down your nose at you. Seems like Endoscopy can be done almost any time, any where (but maybe an empty stomach?)

For the colonoscopy, I assume that it will take about 48 hours tapering off of food (no solids to clear liquids, etc., until I'm just drinking a salty mix that smells vaguely of bubble gum).

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