Monday, September 7, 2009

Treatment to This Point

When Clyde was first diagnosed, her 1st course of treatment included oral chemo. I can't tell you what the drugs were but they appeared to take care of the problem. Over the span of nine months, the lymph nodes where the cancer was collecting reduced in size to the the point that the doctors couldn't detect the disease. The toll on Clyde didn't seem that great either. Granted, I wasn't around much, but I understand that in the course of treatment, she never missed a day of work due to side effects or the illness itself. There was some hair loss and I know there were days that she felt like hell but Clyde is a person of strong will.

The effect that the first chemo had on Clyde's disease lasted for a long time. At her 5 year check-up she was cancer free. The same at 10 years. I think it was 13 years before symptoms returned. We can only imagine how it felt to think you're in the clear only to have the process start over. Again, Clyde's stoic nature hid whatever fear or frustration she was feeling.

In the time that Clyde was in remission, science was making great gains in the treatment of her condition. A new class of drugs called mono-clonal antibodies were developed. These drugs were designed to attach themselves to a protein coating on the cancer cells. They kill the cancer without damaging healthy cells. This all but eliminates the nasty side-effects associated with conventional chemo. Clyde was given a drug called Rituxin. It came in a drip and worked very well and quickly. Again, the cancer was put down and stayed that way for almost 5 years.

After that round, the cancer returned several times and more quickly. There was a round of radiation on one specific spot. Next there was a round of R-CHOP, an acronym for a particular cocktail of drugs. About a year ago Clyde was involved in a clinical trial that nearly killed her. I don't know what she received and I'm not sure anyone else knows either. She wasted away, suffering from the treatment considerably more than from the disease. It was hard to watch. When it was decided that she be taken off the trial and put back on traditional chemo, she felt better. I've never known a person to feel better and gain weight while on chemo but compared to the trial, it seemed easy.

The only downside to going back to a "normal" chemo is that it became evident that it was no longer working very well. Doctors saw improvement in some areas, no improvement in some areas and cancer growing in some areas. Suddenly, Clyde was left with the option of a t-cell transplant for her best hope of the complete remission she had seen earlier in her treatment.

The t-cell transplant option was something we were all aware of. It had been discussed last spring as an alternative. In this scenario, t-cells are "harvested" from a donor by selectively removing them from blood. The procedure is done in two variations. In one, t-cells are harvested from the patient themself and transplanted back. The other process is to take the cells from another person and transplant them. Clyde is getting ready for the latter process.

The best donor for for this type of transplant is a sibling. Each sibling has a 1 in 4 chance of being a good match. Clyde has 4 siblings, there should be a match, right? All four of us went off to the local lab to have blood drawn. When the results were all in, the math had worked in Clyde's favor. She has a match. The transplant could be done should it become the best option.

It's the best option now. In the next several weeks, after all the tests are done, all the hurdles cleared, the transplant will proceed. Bring it on.

Be well.

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