Riding the Melphalan Wave

During the interval between this post and the last, my garden unleashed a bounty of colorful blooms. Iris and rhododendron, in particular, show off extravagant blossoms in lavender, pink, and white. Beneath these preening plants, more humble flowers open their smiling faces to the sun and spring rains. Nasturtium, cosmos, petunia, dianthus, marigold, geums, and daisies: as a wordsmith, I am drunk on the names.

I am also intoxicated with good news from the latest visit with my oncologist.

June Iris at my home in Hood River

June Iris at my home in Hood River

The birthday of my new immune system dates back to August 28, 2008. On that day, I had returned to me my own hematopoietic (blood) stem cells. Those cells rebuilt the marrow environment, destroyed by the chemotherapy drug, melphalan.

Melphalan has a biological half-life of 90 days. That means it takes three months for a body to metabolize half the quantity of the chemo. Therefore, that’s the time to make the first notable measurement of a patient’s cancerous plasma cells. These cells produce excessive proteins, referred to as M-protein or the M-spike. M stands for monoclonal. In other words, the abnormal cells are cloning themselves from a single rogue cell. Eventually, this leads to imbalances in the blood system that, if allowed to continue, proves fatal.

My M-protein at diagnosis in December of 2007 spiked at 4.8 g/dL. That’s high; normal is zero. Ninety days out from the transplant at Thanksgiving of 2008, it was 0.1. A month later, the M-protein again measured 0.1. Those are very good, if not perfect, numbers. The latest lab result, at 283 days, more than nine months post transplant, contained this comment: “The serum protein shows a monoclonal band below the level for accurate quantification.” Evidently, the melphalan continued to eradicate the bad plasma cells. It’s either that or all the red licorice I’ve been eating.

A cream colored rhododendron at dusk

A cream colored rhododendron at dusk

Autologous stem cell transplants are not a cure. But, my drug free remission is a significant benefit of the ordeal we endured last summer. And, it appears to be actively holding its own against the tendency of the abnormal cells to proliferate.

The multiple myeloma support group with whom I meet monthly in Portland keeps me grounded in reality. Through the winter months, we’ve had opportunities to share our stories. Though unique, they have a common theme: multiple myeloma responds to treatment but then returns.

I have not experienced any harmful complications. Thus far, my bones and kidneys are not involved. That, as much as anything, probably explains the favorable response to the transplant.

Eight forms of cancer, of which multiple myeloma is one, cause 49% of the 562,340 cancer deaths projected in 2009. For each of these forms of cancer, at least half of the patients diagnosed will die from their disease within five years. Those cancers are:

Type of cancer

Deaths projected in 2009

New diagnoses projected in 2009

5-year survival rate

Brain cancer

12,920

22,070

35%

Pancreatic cancer

35,240

42,470

5%

Esophageal cancer

14,350

16,470

16%

Liver cancer

18,160

22,620

10%

Lung cancer

159,390

219,440

15%

Multiple myeloma

10,580

20,580

34%

Ovarian cancer

14,600

21,550

45%

Stomach cancer

10,620

21,130

24%

 

Source: Cancer Facts & Figures 2009, American Cancer Society

Those of us with MM are among the elite cancer killers. These numbers without context could easily mislead many to believe we are doomed. For example, the menu of available treatments for multiple myeloma is expanding rapidly. Yet, this table makes no mention of that fact. Read this Stephen Jay Gould link. It sums up my feelings about statistics.

Butter colored nasturtium nestled under a Japanese Maple in my flower bed

Butter colored nasturtium nestled under a Japanese Maple in my flower bed

I feel good. I work fulltime and enjoy many outdoor activities. I try not to anthropomorphize the cancer. I don’t believe it is furtively plotting to attack. What happened to me is an anomaly. Somewhere, somehow, I exposed myself to something that caused my plasma cells to go wacky. They are malformed and don’t die like they should. Drugs and transplants smack them down for a while, but they pop back up like dandelions. It is what it is.

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6 responses to “Riding the Melphalan Wave

  1. Excellent news, John, excellent indeedie! Bravo!
    And thank you for providing the link to Prof. S J Gould’s article. If I could go back in time, I would make more of an effort to get into his course…I don’t remember what was being offered in 1985, but, as I recall, there was a huge waiting list, so I decided on another science course. I am sorry I didn’t persevere, now…
    Some time ago I wrote a post about an amusing sonnet on statistics written by the Roman poet Trilussa. If you would like to read the whole thing, just go to my blog’s search box and type in “Trilussa.” It’s a good sonnet…on chickens! 🙂
    Anyway, statistics are useful in many ways, but we should never forget that we are INDIVIDUALS. Prof. Gould proved this point well by surviving abdominal mesothelioma for 20 years…
    Keep riding the wave!
    Margaret
    Florence, Italy

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  2. John,

    Good news, indeed. And thank you for the lovely floral pictography. The rhododendron was blooming in Pennsylvania as well, last week. I’m a big believer in color therapy as an essential complement to its chemical and physical brethren.

    Hapy Ides of June!

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  3. Dear John,
    My name is Jean and I’m with the National Bone Marrow Transplant Link. Our organization helps patients, caregivers, and families cope with the social and emotional challenges of transplant from diagnosis through survivorship by providing vital information and personalized support services. We subscribe to Google blog alerts, where we found your story.
    Please know that others are thinking of you and pulling for you! If you would like to find out more about our programs and services , you may visit http://www.nbmtlink.org or call 800-546-5268.
    All the best to you!

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  4. Hey, John: That is fantastic, to have your m-protein essentially undetectable. Being tantamount to “normal” must feel pretty nice. It also gives me a hopeful send-off, as I’m slated to enter the hospital on Monday and immediately get Melphalan. Getting other people’s success stories is like having eyes that can look beyond the horizon and see those plants flourishing. Stay well. I won’t see you at support group for a few months, but I’ll be there in spirit. David

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  5. Gr8 !

    My dad is 65 and being treated for MM for last 6 months. He has responded well so far to Thalidomide and Dexa combination. Last visit , the doctor suggested bone marrow stem cell transplant .. We heard conflicting report on that from various forums and confused about going ahead with the treatment.. Some say , he may not be able to cope up with the strong dosage and the whole treatment as such… hapless..

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  6. So good to have found your blog, thanks to Marilyn. I have been missing your musings on life. Glad to have you back.

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