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Saturday, August 11, 2007

In the game ...

MSNBC has posted the entirety of David Gregory's twenty-seven minute interview with Tony Snow about his cancer here. Among many other things, Tony testifies to the power of the concerns others have expressed for him. It's a reminder to keep your thoughts and prayers with Tony and his family as well as anyone else in your life who may be struggling with similar challenges.

Friday, August 10, 2007

Moving Toward a 'Catharsis'

Death is only a horizon,
and a horizon is nothing
save the limit of our sight.
-- Rossitier W. Raymond

PaperQuote [Daily Walpapers & Quotes]

Some who read and responded to my last entry may have been wondering if we are wavering about the the stem cell transplant (SCT). That is not the case. I was just reporting the candor of my physician in terms of the realistic chances for a cure, a probability around 20%. What this confirms: we have known for about 18 months that mantle cell lymphoma is a difficult disease to treat and cure. Not impossible, but not assured despite great advances in treatment of the disease.

Thursday, we had a family counseling session with Dr. Nakamura, Dee Dee, our two daughters, Suzanne and Andrea, and our case manager, Mona Sweinhart, RN, along with a social worker, Carlos, at City of Hope. During the session, our daughters had opportunity to ask their questions and to probe into details about the pending procedure. Both girls left the session satisfied that everything that can be done is being done on my behalf.

We also picked up a new schedule for the SCT that revealed my first five days of treatment, beginning Monday, Aug. 13, will be handled on an outpatient basis. I will not be admitted into the hospital transplant unit until the following Saturday, Aug. 18. The SCT is scheduled Aug. 22.

Meanwhile, what about the catharsis? Dee Dee and I are prepared for the journey, fully expecting that this procedure will give us our best chance of finding a cure. And while we are expecting a cure, we know that the journey comes with a considerable risk and a high potential of side-effects that the medical profession calls "morbidity." For a period of time during the next two months or so, I am likely to suffer ill effects from the treatment alone. The strong chemo and oblation of my immune system, followed by the infusion of the stem cells from the donor, will be the major steps in this process. Of course, we are not expecting complications, but these happen.

In our session Thursday with Dr. Nakamura, he shared his discussion with other members of the medical team. All of the physicians of that group agreed that the SCT is the correct decision. None of them would recommend a different course, although some suggested that in addition to the strong chemo, I should also receive heavy radiation treatment, but since that was a minority opinion, Dr. Nakamura has opted to prescribe chemo only prior to the SCT, due to the fact that my responses to chemo have been good, although not long-lasting.

So, the SCT process begins Monday. Please keep us in your thoughts and prayers as we move into this phase of treatment.
I should add that a great part of our resolve to go forward with the SCT is not just the desire to be healed, but it also has to do with our confidence in our medical team and caregivers at City of Hope. We could not be more pleased with this team and know that providence has brought us to this place at this time.

Wednesday, August 8, 2007

A Crossroads Just Before the SCT

Even though I walk through the valley
of the shadow of death,
I will fear no evil, for you are with me;
your rod and your staff, they comfort me.
Psalm 23:4 (NIV)

Yesterday was a long day at City of Hope. Arriving around 8:15 a.m., we first had an appointment for reinsertion of my PICC line (the temporary catheter line through which the drugs are administered and blood is drawn). The first line became unraveled and unusable last week (not uncommon). All went well with this procedure and it included my routine blood draw for tests.

We then waited a couple hours to see Dr. Nakamura, who was just back from his two-week vacation in Japan. More on our visit with the doctor and other members of our care team in a moment. Later in the afternoon, Dee Dee and I had a class on the Hickman catheter, the so-called permanent line that is due to be installed when I am in the hospital for the stem cell transplant (SCT). Finally, at the end of the day (ending around 6:15 p.m.), I had another round of chemotherapy, hopefully, to help control the tumor growth that has returned just over two weeks since the last chemo.

It is this reality that made our visit with our physician very difficult and sobering yesterday: He shared his opinion realistically and conservatively. Nakamura now believes that the SCT ONLY offers a 20% chance of effecting a permanent cure for the lymphoma, in his opinion. What's more, there is a 10% chance of death from the SCT procedure itself. In every other case, there is a 70% likelihood that something else will occur, including a high probability for a return of the cancer after the SCT.

All of these revelations are perplexing and bewildering. Indeed, they have us at a crossroads in the decision to go forward with the SCT just a few days before our scheduled admission on August 13.

For my part, I am inclined to take the 20% chance because I know not what "miracle" is in the offing. Without the aggressive treatment, we will never know. With it, we may not have the outcome expected or desired.

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