The cancer is in REMISSION

It seems quick I will agree, but as of now the cancer/tumor has been terminated through two rounds of chemo.  I was scheduled for a third round starting next Tuesday, but it has been cancelled and the stem cell transplant has been put on go as of now three weeks early.  IN fact the entire process kicks off July 12^th! I will narrate why this is a big deal and the process by which I engendered this course of action involving a myriad of psychological approaches to ensure my case was handled appropriately.  

                                                         

A little history for those who are not full up on my process.… This is the third occurrence of lymphoma in my lifetime, the first occurring was CNS lymphoma in 2004 while I was flying jets in the Marine Corps.  Following successful treatment and recovery I was clear for 4.5 years.  Then in 2010 I succumbed to stage 4 B-Cell NH Lymphoma while deployed with my Marines. 

This third occurrence was just diagnosed back in May of this year, less than two years after my last chemo.  All the same blood cancer, but the oncologists are calling this a relapse of my b-cell lymphoma in 2010  With a disposition such as this, the standard of care is a stem cell transplant..  With the cumulative effects of chemo on the body’s variety of systems, and the the potential of already having received my lifetime max of certain chemo treatments, the stem cell transplant process was erected in order to rid the body of any possible cancer cells.

The stem cell transplant is actually the process that will rescue my body from the nuclear chemo I will receive in about 4 weeks that is aimed at completely wiping away my immune system.  First they will harvest my stem cells through a 6-8 day process in the hospital, then cleansed via scientific methods, deliver a nuclear” powered 6 day dose of chemo to my body and then  reintroduced my stem cells into my body which will then take about 14 days to regenerate throughout the body and rebuild my bone marrow. Then it is recovery time. All in all a month timeframe in the hospital!

Some of you may ask why not use a donor?  Simply the option to use my own cells has a 50-50% success coupled with a less than 10% complication rate as well as buying me time for future medical innovation in the cancer world.  I am currently working with the oncologists to commandeer and lock in a donor match for the future if need be.  The success rate in this scenario is 80%, but complications increase significantly (over 30%) with using a donors cells.  It could easily kill me with due to graph vs hosts’ disease.  A course of action I would like to save until it’s the Alamo.

A little further background now into why this point is significant and driven through actions related to my previous blog regarding self interest.  Both of my oncologists have stellar, impressive, and successful careers backed with fantastic patient outcomes, however their specialties differ.  One focuses primarily on more standard cancer treatment regiments while the others sphere resides primarily on transplants.  The transplant physician is older with many more years of experience in his field, however my primary oncologist is young, dynamic, educated with empirical experience with MD Anderson the once Mecca of the oncology world….Two powerhouses in oncology.

Initially primary treating oncologist stated that two treatments should be enough, three was ok , but four would be too much as to the possible degeneration of my marrow.  From my personal perspective I told him that if the cancer was gone after two rounds I would prefer to go straight to transplant seeing as another chemo would be provolactic  in its nature and I could do without the near and long term effects of the regiments if the historical data doesn’t prove significant.  I sensed he concurred, but he was hesitant not to disrupt the professional environment with the transplant doctor and his process.

Literally the following conversation happened last week between myself and my oncologist.  As I spoke of previously I was instituting quick and effective change management to his office’s lack luster follow through regarding my PETSCAN vs CT Scan and our conversation veered towards the following.  Doc: “Andy we need to set up your appointment to receive your third treatment.”  Me: “Dr. I’m going to Maryland next week for some needed time with old friends and would like to start on Tuesday the 26 if possible.”  Dr.  “Sure, looking at the time line from the start of your last treatment that would be perfect.”  Me: “ Dr. If the PETSCAN comes back negative why are we continuing with this same regiment of chemo?”  Dr.  “Well Andy this is medical science and not everything is locked down tight and we have to account for the transplant centers time to get their stuff together.”  Me:  “So you are telling me the only reason I will get another treatment is to allow Dr. So So’s office time to coordinate?  Really?!?!  I’m a pragmatic but you have to be shitting me.  I know he’s older, but you have your background and experience that I would like you to leverage.“ Dr.  “Ok Andy we will see.”

Needless to say I was flabbergasted, but remained somewhat practical and calm in my dealings with my doctor.  In my mind I felt this little jab at his pride along with a minor pat on the back would initiate a different course.  Did I devise a full change management plan involved in studying the situation, defining antecedents, outcomes, stake  holders, influence measures, goals, along with perceived end state? Not in the systematic format dictated by anyone of the CM courses, but it was done naturally.  If I deemed it necessary I would have pondered on the matter longer in a more in-depth process, but the action required was obvious to me.  Stand your ground, professionally back your reasoning and make light of a tough situation.  All too often this course of action is retired to the bench.  Everyone loves to laugh and smile and are encouraged by an others delivery of such mannerisms.  Read Dale Carnegie if you want to know moreJ 

Well Wednesday I drew blood once again along with meeting with my primary oncologist.  We have, from my perspective, a good jovial relationship due in large part to my comparison to the vast majority of his patients.  I’m going through one of the roughest treatments for cancer, yet I’m still attempting to live my life somewhat normally, and as Alex says, besides your baldness no one would think you were going through chemo.  Meaning I smile, joke and try to maintain a positive demeanor.  Sure I frequently fall short, but we all do, it’s the point of realizing your actions impact others whether negatively or positively.

Well my Doctor entered and we energetically shook hands and gave bro bumpsJ  He’s young and likes his job from my perspective.  We first went over my levels and he said they are fantastic and well above where we thought. The key level is white cell count for it determines your body’s ability to ward off infections.  He then showed me my  PETSCAN results and said, Andy it’s fried, nothing left, but scar tissue!  I knew this was the result two weeks ago seeing as the majority of my symptoms on account of the tumor had subsided.(ie I could urinate like a normal man, not as an 85 year old man with prostate issues and my BM’s were not painful anymore due to the tumor compressing on my colon had subsided. )

He then smiled and said we are cancelling your third treatment and going ahead with transplant.  I’ve called Dallas Oncology Center and they can do it within the time frame available.  F yeah I thought and said!   Alex was there and the sheer joy on her face to know that my cancer was already gone was soothing, endearing and comforting.

So here we are once again cancer free, however the tough times are still ahead.  The positive is that I have an additional two weeks to prepare the body for the onslaught it will face with the next round of nuclear chemo.  6-8 days, I can handle!  My biggest concern is the 23 days I will be locked in the hospital in order protect my naked immune system from anything out there.

No big deal, I will have family and friends present to assist, a myriad of narcotics to dull the pain and mind of the occurrence and the finest medical team I could conjure up thanks to Alex and her connections.

So did I have any effect on my oncologists new found rigor and drive to relieve me of a third needless chemo treatment?  I truly don’t care, I know that it happening whether my actions promoted it or not doesn’t matter.  It goes back to knowing your situation, what you have at your disposal, what your deficient in, as well as outside variables affecting your path.  Lastly you need decisive action rather than excuses or complacency allowing for inaction resulting in your goal not being met.  One of my favorite quotes from military leadership books/experience is “A well developed, articulated and perfect plan executed slowly and without time management is far less effective than a quick, decisive action erected with minimal planning.”  The point is action.

I find myself onboard a United jet now headed to Maryland where I will link up with old high school friends who have seen me through all three episodes of cancer.  We are having a boy’s weekend at Deep Creek Lake on the western panhandle of Maryland.  Days filled with good/ bad golf shots, comradery, shit talking and inevitable making fun of my bald ass head with its numerous scars, boating activities and simply enjoying the fruits of nature and capitalismJ.  I welcome the hard knocks from the boys.  Too many people take themselves too seriously and sweat the absolute minute bullshit that their lives are filled with hate and discontent.  If most could only grasp, learn or acknowledge the concept of putting their lives or disposition into context and relating it to the mass majority of society they would be far better off mentally.    Take it from a cancer patient who grabs life by the balls every chance he gets, because he knows this shit won’t last forever!

Andy