Cancer

Last night I got the call from my dad about the cancer, it is in fact Stage 4 Lymphoma, which means it has been around for a while. The good news is that the prognosis is good - he can get treatment and the cancer can go into remission for about 10 years. He sounded optimistic - which makes a big difference. My folks have used Shaklee supplements and tried to eat healthy and exercise for as long as I can remember - actually I have very vivid memories of my Dad wakign up the family in the morning doing his Royal Canadian exercises. Anyway - here is his note to the family about the visit:

Had a late afternoon (4pm) visit with the oncology dr yesterday to get the results of the tests. Wouldn't you know it, after calling the doc's office twice before driving to Lafayette to make sure they had received all results back, one test result had not come back yet. It was the biopsy of enlarged nodes in the neck. It had been sent to the Mayo Clinic and was not back yet. It is an important one as far as the doctor is concerned.

My sister and her husband had driven in from Kansas City and my brother and his wife had driven up from Indy and met me at the doctor's office. Their moral support was very much appreciated. Anyway the doc gave me the results of the other 4 tests, but said final treatment recommendations would have to wait until he received the biopsy results.

The bad news is the CAT Scan (the one Scruffy likes because it scorches those cats) showed that the lymphoma has spread throughout the body. There are swollen nodes (tumors) under left armpit, next to esophagus, and in the abdomen. The organs (liver, spleen, etc.) however are clear. The PET scan (the one Scruffy doesn't like) showed the tumors to be malignant. The bone marrow biopsy indicated it has also spread to bone marrow. However, the doc said this was no surprise and expected. This classifies it as Stage 4 (on a scale of 1 to 4, with 4 being worst). It is however slow growing which indicates it has been growing some time before I noticed the lump on my neck.

The good news is that if you're going to have a cancer, this is not too bad of a one to have. It can be treated and the tumors reduced, but it is not curable. Therefore one needs to keep coming back for checkups to see if it has come back (which it will do - it may be in remission for several months to several years) and then go through treatment again. The fact that makes it incurable is the fact that is slow growing. It seems (keep in mind that this is my understanding) that the medicine (chemo or new treatments) attack cells based on their activity, namely how fast they are dividing. Fast growing cancer cells are rapidly dividing and are easily identified and attacked by the medicine. Slow growing cells are not so rapidly dividing and as a result can conceal themselves from the medicine and not all of them will be recognized and attacked. As a result some of them avoid detection and may remain in one's system after treatment is completed, to rear their ugly head at a later time. Thus it is not completely curable. The main danger from lymphoma is the tumors becoming so enlarged that they may exert pressure on other structures, or spread to organs, or replacing bone marrow fluid with lymphatic cells, thus reducing the body's capabilities to produce a good blood supply. My blood test looked very good, so that was a relief. More good news is that life expectancy for lymphoma with current treatments is good : 7-10+ years

Treatment options are as follows: 1) do nothing at the present time - wait and watch for symptoms to occur - I feel great right now, 2) a combined treatment regimen of Rituxan ( new treatment) and chemo, or 3) get accepted for a clinical trial using Rituxan only. Rituxan is a new treatment and is not a drug like chemo. Thus there are not the usual side effects of chemo. Rituxan is a protein antibody which has been programmed to recognize and destroy cancer cells only and it is very effective. Each cancer cell carries a marker identifying it as foreign body cancer cell (CD-20 marker- as Chip says - like a neon sign saying here I am) and the Rituxan attacks it only, not good cells. The Lafayette Cancer Care Clinic is currently conducting a Rituxan clinical trial (Phase 3 - meaning that the drug has previously proved successful and each patient is treated - no placebos are used) and the doctor will see if I qualify. There are certain restrictions in that the tumors cannot be too bulky (exceed 7cm - I have a couple around 6cm). I think it would be a blessing to get in on the trial because Rituxan seems so successful, no side effects as with chemo, plus you are monitored very carefully in the trial.

I have an appointment with the doctor on Tues 2/22, to review biopsy results and finalize treatment plans. Of course after all this, I can get a second opinion, but at the present time I feel pretty confident with Dr K. I have in effect already had 2nd opinions in that 3 different Pathology groups (including Mayo) have reviewed results and offered opinions re type of lymphoma. We'll see. Keep those prayers and thoughts coming and ask the Spirit to guide Pat and me. Also it's kind of hard on Pat, so keep her in your prayers also. Thanks family and friends.