Consult with stem cell specialist

After talking to Dr. Miller again, Doug agreed to see the stem cell transplant specialist, Dr. Jeff Matous, at Rocky Mountain Cancer Center in Denver. We saw Dr. Matous on 2-6-09.

Dr. Matous felt that Doug has had "an amazing response" to the initial chemo. He explained that Doug has options:
1. Stay on 'regular' chemo and no SCT (stem cell transplant). The downside of this choice is that the drugs lose efficacy over time: the cancer cells get 'smart' and develop a resistance to the drugs. Then other drugs are given. Also, the side effects of the drugs usually worsen over time.
2. Harvest Doug's stem cells now and then wait until later to do a SCT.
3. Harvest the stem cells now and go right into the SCT. Dr. Matous feels that #3 is the best option. He explained that because Doug is in good shape now, he will better tolerate the SCT prodecure, and it will give him the best chance of a good remission. According to the stats, after a SCT, the average remission is two to five years before the disease comes back. But then there are options for treating it again.

Doug decided to go with option 3 - doing the SCT soon.

Dr. Matous did not go into all the details at this visit, but we know Doug will lose his hair due to the high dose chemo. It will grow back. There are other fairly serious side effects and I'm sure those will be explained in detail later. Doug will have to undergo a whole series of tests and procedures to make sure he is healthy enough to have the SCT since it will be a jolt to the body. That includes another bone marrow biopsy, not something Doug looks forward to.

Dr. Matous did say that the SCT will be done on an outpatient basis -- at the Rocky Mtn Cancer Clinic, which is on the Presbyterian/St Luke medical center campus. Only patients who have a 24/7 caregiver (that would be me) can do it as outpatients. We will have to stay in Denver for at least 30 days.

I am writing this on 2-12-09. We got a call this afternoon from a member of the transplant team -- the social worker. She is going to do the "psychosocial interview" with Doug by phone tomorrow since we live a distance away. She said this will take about an hour and is a mandatory part of the SCT preparation. Seems that mental/emotional health is checked as well as physical! Actually it is great that they want their patients to be well prepared.

This is going to be a big deal, but at least we have a plan of action. Now that he has decided, Doug is working on keeping a positive outlook although there is understandably a bit of trepidation.