The Stem Cell Transplant is On – 17 November 2015 (Cancer and Me 41)
Yesterday I went for my appointment at the Southampton Hospital Oncology department. I met with one of the senior doctors and the transplant co-ordinator, the same people I met back at the beginning of 2013 when my stem cells were harvested.
He seems to be a doctor who likes to describe the various options, even if the decision turns out to be a no-brainer. The options he spoke about were:
- Do three more cycles of Bendamustine and then wait for lymphoma to come back. That’s the least intrusive, but the remission would probably only be about 12 months.
- Autologous stem cell transplant, which is what we’ve been preparing for. They still say there’s a 50% chance of a total cure (greater than 10 years of remission). I’ve spoken about the potential complications before, so won’t repeat myself. He mentioned again that 1% of people die of infections as a direct result of the high dose chemo, but this time he acknowledged that the risk in my case would be much lower because I am young, fit and strong.
- Allogeneic stem cell transplant. That’s the same procedure except using somebody else’s donated stem cells. With this one the chances of success are higher. But the risk of death is also higher, because of the risk of my body rejecting someone else’s cells. And the fatality risk is significant (more than 10%).
So we confirmed that the plan we’d spoken about before was still the right plan. Autologous stem cell transplant. The allogeneic version is something he said that we could keep in reserve for “if we get in a tight spot at a later date”.
The idea was that they would have the results of the PET CT scan, but they had not been reported yet. If those were all clear we’d be able to go ahead with the transplant. If there was any lymphoma activity showing up then I’d be given one more round of Bendamustine before going ahead with the transplant.
As far as timing is concerned, this is where there was a bit of a surprise for me. I’d evidently started to convince myself that they would book me in for January, whilst verbally acknowledging the chance it could be soon. So it took me a while to digest the words, “if the PET scan’s ok then we should be able to get you in in a couple of weeks!”
Anticipating the question that was written all over my face, he said, “you’re going to ask me if we can wait until after Christmas, but I don’t think we should do that.” His reasoning was firstly that there will always be reasons to wait. More importantly, though, the lymphoma is coming back (albeit slowly) all the time, so it makes more sense to try and consolidate my remission as quickly as possible.
But this means that with an average hospital stay for a stem cell transplant being around 3.5 weeks, I am likely to be in hospital for Christmas, and definitely on Anna’s 13th birthday (22nd December). It won’t be the first Christmas I’ve ruined (2009 being the other obvious one, but I’m not forgetting that I was made redundant in December 2001, again in December 2005 and again in December 2007)!
The PET scan results were reported this morning – all fine (although I’m still slightly nervous having been told that the doctor still has to confirm formally). So I’m now just waiting to hear what the dates are for the next steps… PICC line to be fitted, kidney function test and echo cardiogram, as well as another meeting with the doctor and transplant coordinator.
The kids took the news surprisingly well, partly, I think, because they knew it was coming. They were obviously disappointed about me probably not being around for Christmas. Anna brought tears to my eyes. When I told her she just gave me a massive hug, smiled and said, “Dad, I don’t mind that you won’t be around for my birthday or Christmas Day. I’m just happy they’re going to make you better.”
So there’s lots to think about, lots to prepare (finances being one of the big ones) and lots of people to tell. In the meantime I’ve got to try to extricate myself (again) from work, leaving the insanely busy project to be finished off by others. And yet again I’ve only got a few days to do it. I admit to feeling emotional about it. I’ve been at Ageas for over four years – a short term contract that has lasted longer than any of my other jobs except one. The people there are fantastic and I will miss them immensely.