Okay. Here is what is happening: Monday 9:45 a.m. MST I get chest/abdominal/pelvic CT scans; usually they are read and reported out late the same day, so I should be able to report outcomes on Monday late afternoon, or Tuesday morning, here at the latest. I asked AbJ how often he had seen a reversal of outcome during tx. That is, a positive outcome by the end of the third cycle and a reappearance of the disease after the sixth cycle. Answer = rare, but he has seen it once or twice. Since he has been in the game for near a couple decades, odds are in my favor.
I will report every 6 weeks between now and 6 months to get my port flushed. On the second and maybe 4th of these occasions, I will see him to discuss my general health. That is the extent of the monitoring process. Then at 6 months I get four maintenance sessions, one per week for four weeks of the Retuxin (R of the R-CHOP). With no changes in health, i.e., a maintenance of the status quo, I will get four of these maintenance sessions over a two-year period. I assume that those interim months will also be taken up with port flushing and checking on my general health. After that: bupkis.
What am I to look for, I asked? Any untoward changes in my general health was the answer. The sort-of big ones, of course, are unexplained weight loss (non interest in food), night sweats, and swellings that don't resolve.
The onc docs assume a direct correlation between length of remission and non-aggressiveness of the disease. And, therefore, the length of the remission will determine Plan B, if there needs to be one. For example, if remission were short (a few months?) he assumes because I am robust (tada!!) that stem cell transplantation would be a good option. But if remission is longer (e.g., years), then a repeat of some part of the current therapy is possible. Usually, they go with the Velcade (damn!) because one of the parts of the R-CHOP is considered too toxic to go through all of that again. His other patients apparently tolerate the Velcade better than I, though I may be mis-attributing here since I have never had the Velcade alone.
The outcomes of his several other MCL patients are good. All are apparently in remission. One has completed his two-years of maintenance and is at this reporting disease-free.
So back at this stand by Monday-Tuesday of next week for an update on the CT results. Until then, hoist a glass.
Hear hear!
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