Sometimes we say in Spanish, "hay peligro de que sobreviva", "there is danger that he survive", which pretty much describes my experience today. Good news in general.
Two great mexicans went with me to Dana-Farber this time. Thanks a lot Miren and Laila! Seriously, you were great company!!
We got there at around 8:45 after the long waiting and crowded cars of the E Green Line, and chatted for a while until I was called in. They weighed me and measured and took my blood pressure and pulse and respiration rate. How come every time they weigh me, I weigh more than the previous time? Wednesday last week it was 192, today it was 202. I can't have gained 10 pounds in less than one week, can I? Did I? Does it look like I have? Anyway, they thought gaining weight was the best thing in the world for me. I don't really agree.
First I saw a nurse practitioner who asked me to tell my story to her. She said she had all the medical records but wanted to hear my version, how I lived it and was living it and felt it. That was cool... humane. Then she asked lots of questions about my familiy history and was impressed to hear the an uncle, an aunt, and a grand aunt on my mother's side had died of cancer, and an uncle on my father's side had too. She then said my PET Scan showed very positive results and went to call Dr. LaCasce.
She came in a while later and started by explaining what Hodgkin's was and telling me that I had mixed cellularity type Hodgkin's, which means that cancer cells are mixed with other types of cells, like lymphocites. This makes it hard to detect through fine needle aspirations like the ones I had before the the surgery.
She then explained to me that the most common treatment for my kind of disease is 4 months of chemotherapy followed by 1 month of radiotherapy, and that the results were very positive: cure rates of around 90% in early stage Hodgkin's. Mine is a Stage 2, early stage, meaning that only one side of the body is affected and all is above the chest, which is good. Those were the good results from the PET Scan.
She then explained to me that one of the drugs in the chemo might be bad for the heart and another for the lungs, they all might cause nausea, and they all might cause loss of hair. They will monitor my heart and lungs during the treatment... additional tests, yay! It doesn't seem too bad anyway... I shaved my head for a year while in the army and I've been drunk and hungover (nausea)... nausea can be controlled with drugs, and as far they monitor my heart and lungs, I will be fine. Maybe the shaved head will look good, who knows... it seems to work for Seth, right?
She also said there was danger of reproductive problems with chemo and that I should consider a sperm bank just in case. ABVD, the kind of chemo I will get doesn't seem to affect sperm counts, but I should consider it anyway. I do wanna have kids eventually, so I'll call and inquire. Not sure yet, but I'll find out about prices and stuff.
After Dr. LaCasce, I went to see Dr. Mauch, the radiation therapist/expert. He really is an expert. He is all over PubMed if you search for Hodgkin's. It took a long time to see him. I got measured and weighed and poked and so on again, talked to his resident and waited, and waited, and waited. I waited so long that I went back to the waiting room and asked Miren and Laila to go to class and back home. They'd been there for a long time and had work to do and classes to attend. They left.
Finally, after a long, long wait, Dr. Mauch came by. He agreed with Dr. LaCasce about the treatment recommendation (I was there for a second opinion) and gave me some more information about a medical trial I was invited to consider by her: using more/different chemo and no radiation therapy. Why no radiation? Because when done in the chest it may cause coronary and pulmonary problems and maybe pulmonary cancer in active smokers (remember I quite). In my case, since there are no lymph nodes in the chest or stomach, that area won't be irratidated, so the risk is minimum, he explained.
The side effects of the radiation don't seem too bad: sore throat, thickening of saliva for a few months, some loss of taste (it comes back), fatigue and skin redness in the area. It all seems manageable, so I will go for the regular standard treatment: 3 1/2 weeks of daily radiation after the ABVD chemo is over. The appoinment finished with awkward silences and me asking random questions to try and make it better... "hmmm... what are the side effects of not having radiation... or errrrr of having it... orrrrr of the thick saliva... hmmmmm... what do you re-recommend...... hmmmmm... hmmmmm... hmmm... thanks, then... errrrr see you soon... orrrr errrrr in four months... or errrrrr... hmmmm... bye then." You can tell Dr. Mauch isn't the most charismatic, right? He did come across as knowledgeable and trustworthy, which are good characteristics in a doctor.
Later I had a pulmonary test and some blood drawn and was back in Harvard Sq. by 4:45, just in time for dinner. Besides, I was there for only 7 hours!! Amazing!!! I was so tired when I left, and it was such a waste of a day academically... no reading got done, except for some accounting, and I still have lot's of Ilona and some Kate work to do... this week started pretty badly on that front.
Anyway, the news is good, it seems I'm gonna be O. K., survive, etc...
- Friday March 4, 8:30AM: heart pumping test @ Dana-Farber.
- Thursday March 10, 2:00PM: 1st chemo session at Dana-Farber.