Stanford Advanced Medicine Center
On Monday we had an appointment for a consultation at Stanford University’s Blood and Bonemarrow Cancer Clinic.
I was very apprehensive about this appointment since it was made a few weeks ago. I’ve been quite concerned that he would get his hopes up, as would I, only to have them blown away. There was a very real possibility that we could have been told that he was to old, or that his cancer was to far advanced to be treated with a stem cell transplant.
The good news is, he has responded well to chemotherapy, and was given two options for transplant. Option A, is a stem cell transplant using cells from a sibling if one is a match. The upside to this sort of transplant is that the cells are from a healthy cancer free immune system. Essentially a stem cell transplant is a transplant of your immune system. Stem cells are the seeds to the immune system. With option A, fresh healthy cells, would serve to fight off any remaining cancer that was not destroyed with the high dose chemotherapy that is a companion to transplantation. The downside is the cells from a sibling may recognize they are not a part of his body, and reject his body. A reverse rejection essentially, meaning the cells do the rejecting not the body. This as I understand it, is fatal, always.
Option B, the one we chose…well he did, I didn’t want to be involved in that decision other than being there to support whatever he wished. This option involved harvesting his own stem cells once we have given enough chemo that possibly has knocked back as much of the myeloma as is possible. So there will be two harvests, and when he is done with the high dose chemo, they will reintroduce the harvested cells into his system. The upside of this is no chance of the horrible and fatal rejection obviously. The downsides are the possibility that the harvested cells will either not reproduce and grow once back in his body, or they will not be clean enough of myeloma and he has a rapid recurrence of the disease.
There are other risks involved in this transplant no matter which option is chosen. When you use such high doses of chemotherapy, the bodys immune system is destroyed, even a mild virus or bacteria can cause serious illness and even death. Also there is a risk of major organ failure. The information binder I was given gives small percentage chances for such things happening, but these are real concerns and fears. Ofcourse without treatment of this nature, there is no way to know how long he will live, and the reality is he will die if we don’t do something.
So with the option chosen and decision to go ahead made, we now will go through atleast one more session of chemo with his oncologist. Then sometime not long after they will do new biopsy and screening to see how the chemo has progressed. If they feel his myeloma counts are not low enough, we will do another chemo locally. If they feel they have gone as far as they can with the regular chemo then we will begin the process of the transplant.
As I understand it the first step is having a catheter installed in his chest to be used for the chemo as well as to draw blood and give other injections, so they wont be poking him daily with needles. Then they will stimulate the growth of his stem cells and force them out into his blood stream for harvesting. This will be done twice. For this part of it we can live at home.
When time comes for the actual transplant, we will have to be living close to the University, for about a month. They call this the ‘safe zone’. So I will have a very sick man on my hands, in a motel room, hopefully with a kitchenette, as we wont be able to eat out or order in, he will be on a macro biotic diet, meaning all foods have to be fully cooked and certain things he has to avoid such as having anyone else prepare his food. This is avoiding putting him in hospital for this part of it. They feel that the bacteria and virus in hospital are far more dangerous than those found outside. He will also have to wear a hepafilter mask to keep him from breathing anything in that can make him sick.
Its all very overwhelming and frightening, but now we just go one day at a time, one thing at a time, and try not to look to far ahead yet.
When Cancer Strikes 
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