Oncology Visit

Today we had the appointment with the medical oncologist who has been doing the follow ups on Doug. The last time we saw him (Oct 26) we were told that Doug was still in remission, and that his hip pain was probably 'arthritis'. A week later, after CT scan results showed lytic lesions (bone destruction), the oncologist called us on the phone to tell us that Doug is not in remission and he needed to go for radiation on the hip. The reason his relapse was not noticed before: the myeloma has 'mutated' into light chain disease (nonsecretory myeloma), thus there is no M-spike on the blood work. (Actually the elevated light chains did show on the blood work but only the M-protein was being followed. Don't get me started on that.) All this is background info; I have told you the details in earlier posts.

Today, as we had been told on the phone, Dr. M said that Doug needs to go back on chemo to try to get this under control. Doug will go back on the same drugs that controlled the myeloma in the first place. The drugs that he took before the stem cell transplant: Revlimid and Dexamethasone. He had a good response to the drugs in 2008. Both these are in pill form and can be taken at home. That's good.

The Revlimid is a highly controlled drug, also a very expensive drug. We have applied for a grant that would help cover the expense, since even with insurance out of pocket costs are high.

Dr. M also recommended that Doug go back on Zometa (a biophosphanate drug to strengthen bone - not a chemo drug). Zometa is given via IV at the local hospital. We were told that there is a higher risk, now that Doug has already had two years of Zometa, of necrosis of the jaw. Just a quirky little possible side effect. Necrosis is bone death; if that happens it would probably entail major surgery of the jaw bone. It is a low probability. The benefit/risk ratio favors going ahead and doing the Zometa. The aim of Zometa is to strengthen bones and prevent more lesions in the bone, and prevent possible fractures. The first time around Doug got Zometa every month - this time it will be every six weeks.

Dr. M also ordered a 'skeletal survey' to be done. Basically plain x-rays of the bones most likely to be involved - skull, pelvis, spine, long bones of arms and legs. This will be done next week, and will show if there are any lesions present now that are not symptomatic yet.  

Doug will get two cycles of Rev/Dex chemo (two months) and then will get re-evaluated to see if there is a response. If yes, great news. If not, we will seek a second opinion and formulate a Plan B.

That's the news for now. I am glad to be taking action to fight this disease. Our spirits remain high.

"May the God of hope fill you with all joy and peace as you trust in him."     Romans 15:13