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Tuesday, March 31, 2015

Farber Visit

Yesterday I went to the Farber again for my monthly checkup and (gulp!) a bone marrow biopsy.  Fortunately, my blood test numbers still look great.  The biopsy was another matter altogether.  My nurse practitioner, Katherine, was very sweet, but I missed Zack.  Zack was very good, so I was apprehensive without him.  My concern may have contributed to my being more sensitive to the pain of the procedure.  Ouch!  In any case, it was pretty uncomfortable, so Katherine suggested that the next time I should consider using medication.  I agreed with her, so next time I plan to be in la la land during the biopsy and it will be great!  I think I'm done with this macho routine.  As I get older, I think I'm ready to let go of my readiness to meet the challenges of life with all this bravado.  OK, just give me medicine.  It's not like I'm a war prisoner trying to protect our country's secrets.  I don't think I'd be very good at that.  So just knock me out, OK?

In my last post, I failed to note a significant milestone in my life.  On March 20, I celebrated my 3rd birthday anniversary of my new immune system.  We were in Hawaii at the time, so the event kind of passed unnoticed.  I'd like to take the time now to celebrate that.  Yippee!  Happy third birthday to me!  I am still in remission, which is awesome!  In another few months, I will be done with the Protocol I'm on, and I will stop taking the Revlimid.  After that, I will just go on living my life and wait for the inevitable to happen...eventual remission.

How long will that take?  I don't know.  I just read an online article about the utility of using flow cytometry to measure Minimal Residual Disease (MRD) in MM.  Here is a link to the article:  The basic message is that no MRD after initial induction is a really good thing and provides an independent measure of future prognosis.

Fortunately, I was diagnosed with no MRD after my initial MLN9708 treatment and also after my ASCT.  So I should be on the upside of the survival statistics.  Yes, I am, but from these data, that doesn't bring me a whole lot of comfort.  For those who achieved MRD, the median Progression Free Survival (PFS) was about 5 years, and the Overall Survival (OS) was about 7-8 years.  Wholly crap!  Based on these statistics, I don't have a lot of time left.  On the bright side, these data were based on earlier treatment regimens and don't account for all the new research and the myriad of recent treatments available for MM patients.  Therefore, I remain hopeful for a number of years of PFS remaining, and when the inevitable recurs, I expect a host of new options to extend my OS for a long time. So that's my optimistic assessment on all this.

There is a great miniseries now airing on PBS:  "Cancer, The Emperor of All Maladies".  It is presented in three 2-hour segments which aired yesterday, today and tomorrow.  I read the book and it is outstanding.  If you aren't watching it, look for it to repeat.  It illustrates how important Dr. Sidney Farber's influence was in the fight against cancer, along with many others.  It's a very thorough analysis of a very difficult disease but gives a lot of hope for the future.

It's all good!

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