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Saturday, March 21, 2020

Another Long Absence

It has been almost a year since I updated this blog.  I apologize for the long absence.  Fortunately, since then I have continued to be in remission from the MM, so there has been nothing new to report.  That is the main reason I haven't updated this blog for so long.  By the way, yesterday was the 8th anniversary of my stem cell transplant, so Happy Birthday to me!

While I am still doing fine with the MM, there have still been some recent developments that could impact my prognosis going forward.  Being of Irish heritage with fair skin, I have had my share of skin cancers over the years.  These have normally been either basal cell carcinomas or squamous cell carcinomas, which have usually occurred less than once a year.  After a MOHs surgery for a squamous cell on my forehead in December, 2018, I was fine for my next diagnostic scan in May 2019.  However, on my next visit in December, 2019, my dermatologist took five biopsy samples.  To my chagrin, all five came out positive!  Gulp!

Four of the five malignancies spanned the range from two basal cell carcinomas to one squamous cell carcinoma in situ and one moderately atypical nevus.  The pathology report described the fifth one as an "atypical intraepidermal melanocytic proliferation consistent with early, evolving lentigo maligna".  I spent some time on the Internet trying to decipher this gobbledegook.  That one was of the most concern, as it was basically a melanoma in situ (Stage 0 melanoma).  My dermatologist wanted to deal with that one immediately, so I quickly had that one removed from my neck.  I was able to deal with the squamous cell on my forehead using an ointment for a few weeks, and I had the others on my arm, back and leg surgically removed over the next couple of months.

I have been on maintenance therapy using Revlimid (lenalidomide) for my myeloma for the past 8 years.  While Revlimid has been a Godsend in helping to keep my MM in check, it has the known side effect of occasionally spawning secondary cancers.  So I decided to make an appointment with Dr. Richardson to discuss whether I should keep taking the Revlimid.  I met with him this past Monday.  He pointed out to me that the high-dose Melphalan I took to kill my immune system when I had the stem cell transplant is also known to cause secondary cancers.  The combination of the two agents may well have spurred my sudden increase in skin cancers, so Dr. Richardson recommended that I stop taking Revlimid.  So I did.  The good news is that I won't have to keep shelling out an average of over $900/month in copayments for the Revlimid.  However, what am I going to do without my blankie?

Since I'm now off the Revlimid, I will no longer have to go back to Dana Farber on a monthly basis for blood tests and checkups.  However, I will still continue to have infusions of Zometa every 3 months for my bone health.

While I was with Dr. Richardson, I asked him whether he considers me to be high risk regarding COVID-19 due to the MM.  He was very encouraging about that, as I am in remission and my immune system is not compromised.  Of course, I still have the age factor to deal with.

Hopefully, I will update this blog within a reasonable time frame to let you know how I am faring with this new normal.  I guess we will all have to adjust to a new normal with this Coronavirus.  Stay well!