Friday Cancer Blogging – 24 October 2014

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A few of you have probably cottoned onto the fact that people don’t usually spend a week in the hospital for a broken bone, even a backbone. So in the long tradition of releasing bad news on Friday afternoon, here’s my first-ever Friday news dump.

When I checked in to the hospital Saturday morning, the first thing they did was take a bunch of X-rays followed by a CT scan. These revealed not just a fractured L3, but a spine and pelvis dotted with lytic lesions that had badly degraded my bones. That’s why a mere cough was enough to send me to the ER. It was just the straw that broke an already-weakened camel’s back. Later tests showed that I also had lesions in my upper arm, my rib cage, and my skull—which means that my conservative friends are now correct when they call me soft-headed.

The obvious cause of widespread lytic lesions is multiple myeloma, a cancer of blood plasma cells, and further tests have confirmed this. (The painful bedside procedure on Tuesday was a bone marrow biopsy. Bone marrow is where the cancerous plasma cells accumulate.)

I know from experience that a lot of people, especially those who have been through this or know a family member who’s been through this, will want to know all the details about the treatment I’m getting. I’ll put that below the fold for those who are interested. For the rest of you, here’s the short version: I’m young, I’m not displaying either anemia or kidney problems, and treatments have improved a lot over the past decade. So my short-term prognosis is pretty positive. Treatment involves two to three months of fairly mild chemotherapy, which has already started, followed by a bone marrow transplant. My oncologist thinks I have a very good chance of complete remission.

The longer-term prognosis is less positive, and depends a lot on how treatments improve over the next few years. But I figure there’s not too much point in worrying about that right now. Better to stay focused on the current regimen and see how I respond to that. Wish me well.

OK, here are all the gruesome details of my treatment regimen. Yesterday I had a kyphoplasty, which we hope will repair my fractured lumbar bone and relieve my immediate pain. Once a month I’ll be getting an IV infusion of Aredia, a bone-strengthening medication.

Because I’m young and my symptoms are mostly limited to the bone lesions, I’m a good candidate for a bone marrow transfusion. For that reason, my oncologist has recommended treatment with three drugs:

  • Decadron, a corticosteroid
  • Velcade
  • Cytoxan

I’ve already begun the Decadron treatment, and I’ll start the other two later today. The total treatment cycle is 2-3 months. It’s supposed to be a fairly mild regimen with not too many hideous side effects. We’ll see. As usual, the drugs put me at higher risk of infection, so I’ll be taking Acyclovir as a prophylactic antiviral.

Assuming this all goes well, it will be followed by a bone marrow transfusion. Basically, they suck the blood out of my body, filter it, and pump it back in. There’s more to it than that, of course, but we’ll take these things one step at a time.

That’s basically it. Obviously there will be loads of ongoing tests and imagery to see how things are going, and I’ll continue to have to watch carefully for signs of relapse for the rest of my life. For the time being, though, I’m alive and my prospects for staying that way seem pretty good.

UPDATE: I forgot to ask until later, but my particular cancer is Stage 3.


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