plasmacytoma vs. lymphoma?

The biopsy of the lump on Doug's right anterior chest wall (near the port) was done 5-15-20.
On 5-20-20 we got the pathology report from HRRMC. It said: "Favor soft tissue involvement by plasmacytoma, versus large B-cell lymphoma. Mayo pathology consult pending."  We were surprised to read that! Based on appearance and Doug's history of plasmacytomas, we, including the oncologist, were sure it is a plasmacytoma. We still do not have the final report from Mayo. The NP at the infusion clinic says it would be "very unlikely" to be lymphoma. We want to see that report!

When Doug first started the Kyprolis, Cycle 1, day 1 & 2, the protocol called for a reduced dose of 40 mg.
The next week, days 8 & 9, per protocol the dose was increased to 100 mg.
Then Doug had the weight gain and edema of his legs ankles and feet. So the following week, days 15 & 16, the oncologist reduced the dose back down to 40mg out of caution.
The next week was his rest week - no chemo - and he felt better with more energy. Both the Denver specialist and the local oncologist agreed that we need to get the dose back up.
So yesterday and today, cycle 2, days 1 & 2, the dose went up to 60 mg. We are watching closely for edema and weight gain. We'd like, if possible, to go up to 100 mg which is what it should be per protocol. But only if he can tolerate that dose.

Yesterday the nurse could not get the port to draw - meaning blood would not come out, but sterile saline would go in. That happens occasionally, and usually changing position, raising the arm, laying him way back in the chair, or other movement, will do it. Not this time. So Doug had to go to radiology for a 'dye study'. That showed the dye going into the port and going where it should go in the body. Good! Sometimes a small clot or fibrin sheath will form at the end of the catheter tip and act kind of like a one-way valve. The dye study showed it was safe to use the port for the chemo. We were glad of that. After yesterday's chemo was finished, the nurse injected a tiny bit of a drug (cathflow) that acts as a 'clot buster'. This morning it was sucked out, then the port was flushed and it it like new.

Yesterday Doug weighed 162, this morning 164. We will keep checking it as well as watching out for increased edema.

We both enjoyed Doug's week off treatment. He was able to walk around the loop with me and the dogs, and drive our new car that has all the new safety features.

We are depending on God for endurance, strength and peace. We appreciate all of you who pray for us!

This is one of my go-to Bible verses:

"Do not be afraid, for I am with you.
Do not be discouraged, for I am your God.
I will help you and strengthen you.
I will hold you up with my victorious right hand."
Isaiah 41:10