The Plan

Today, Teresa and I visited Dr. Selby at OU Medical Center, then with Dr. Thompson, who will be my radiation oncologist. Boy, did we get an earful! Our brains are still trying to process all of the information. It's kind of like our brains are 5 pound size bags, and they were trying to stuff 20 pounds of stuff in them. Anyway, fasten your seatbelts, here's the dealio.

As previously written, the bone marrow biopsy results were negative, meaning no cancer cells in my bone marrow. That's good. Selby told us about the CT scan result. It shows an image in my abdominal area that is very likely nothing but scar tissue from previous chemo treatments and tumors in that region from before. That's what they think and they are sticking to it. My recent blood work has all come back normal. So, that all adds up to the conclusion that there are no, or very, very few, cancer cells anywhere except the lump in my neck just below my jaw. That makes me an excellent candidate for radioimmunotherapy (described in an earlier post, but I'll be glad to cover that again if anyone wants me to). There are two choices, or types, of radioimmunotherapy. One is Bexxar and the other is Zevalin. And the winner is...BEXXAR, by GlaxoSmithCline Labratories!

Bexxar treatments will begin on 1/2/09. There are only two treatment days, unlike chemo that takes weeks or months. The next treatment date is 1/9/09. In the meantime, I'll have at least one more blood test. The first treatment is called the dosing treatment. I'll be given a small amount of the drug, then tested almost daily during the week until the next treatment. The purpose of dosing is to determine how quickly the drug clears out of me. Fast clearing = higher dose, slower clearing = lower dose. I'll have three special scans and more blood test. The scans are done by a machine that specifically detects and tracks traces of the drug. It's probably an old Geiger counter from the 40's that was used after nuclear bomb tests, but we'll act like it's a brand new, cutting edge technology thing-a-ma-jig just to make the doctors feel important. By 1/9/09 they will know how much of a dose to give me, that's called the therapeutic dose. It delivers what should be all of the drug that I'll need to knock out the cancer.

We should know by the end of January if it worked, or is working, just by seeing if the tumor starts shrinking. I'll have weekly blood tests for 12 weeks after to watch my blood cell counts. I will probably experience low blood counts, possibly down to dangerously low levels. My immune system will be more or less in a tailspin, so no visitors, please. I don't want to catch your nasty viruses. Blood counts should be back to normal in 2 to 4 months after treatment. Low blood count, called cytopenia, is the most common and most likely side effect. Hypothroidism is another potential side effect. I'll be given medication before the treatment to counteract that possibility. More thyroid drugs may be prescribed if needed. Fatigue will be a big deal, they said, as a result of the cytopenia. So give me a break if you see my lazy ass spread all over the sofa all day (I know that's not much of a change, but now I have an excuse). As with any cancer drug, there's a list of potential side effects about a mile long. Rather than list them all here I'll just talk about them in future posts if they appear.

I asked the doctors what I could do nutritionally to try to reduce side effects. When I suggested Scotch as a therapy, he disagreed. I think he's wrong. I will conduct my own clinical trial on that. He did say something that I liked. He said I should take mult-vitamins with iron, and to EAT LOTS OF RED MEAT! My menu will now consist of cow for breakfast, cow for lunch and cow for dinner. I'll have a t-bone with sides of cheesburger and roast beef. I'll probably start mooing.

As for work I'll continue with that until I can't due to fatigue or severe cytopenia. It gives me something to do and I get paid. I need to get paid to buy more fishing lures.

There are lots of details associated with this disease and treatment. I'll put up more posts to fill in the details. It really can't be all covered here at one sitting.

I've read all of the comments and appreciate every one. Keep them coming. Don't be shy about asking questions. I'll answer every question you fire my way.

To be continued...