Day 110

You reach some points in your life where there are forks in the road and you have to choose what direction to go. Those moments can fill you with self doubt and trepidation. Our visit with Doctor Rowley at Hackensack University Medical has brought us to such a moment. Here's the result of the consultation.
The test results over the four months since the transplant show that the cancer is the same as it was before the transplant. In other words the transplant had no discernible impact. The chemo before the transplant reduced the cancer by 90% and that's where it rests today. The team outlined four courses of action to select amongst:

1. Wait, watch, monitor and commence treatment when the disease starts to progress.

2. Commence a chemo regimen to hold the disease in check and go to more aggressive regimen when the disease starts to progress. The danger in this approach is that the disease will become resistant to the chemo being used and it will no longer work to curb the disease.

3. Do another Autologus Stem Cell (my own stem cells) transplant under a Clinical Trial chemotherapy protocol which is more aggressive than the one used in my first transplant. This could leave me with a better response, or not, awaiting a relapse and perhaps an Allogenaic (using brother Ed's stem cells) but with a decreased chance for successful results.

4. Allogenaic (Ed's cells) Stem Cell Transplant. They are looking to do this in early June. This process replaces my immune system with Ed's immune system but it has the following risk/reward scenarios:
A. I could get severe GVHD (graft verses host disease) where Ed's immune system perceives my body as the enemy and attacks and destroys it. There is a 15% chance that this could happen and the result would be death shortly after or during the transplant process.
B. I could get chronic GVHD which would mean being on strong immunosuppressants for the rest of my life but I don't know how long that would be and my quality of life would be greatly impacted. I have to check on the percentages relative to this possibility.
C. I could get mild GVHD with strong GVM (Graft Verses Myeloma) in which case the GVHD would disappear and the Myeloma would be cured. I also will have to check on the percentages for this result.
D. I could get mild GVHD with no GVM and also don't know the percentages.

Anyway, this is the crossroad at which we find ourselves. All of your observations and inputs will be appreciated. Thanks.

Day 93

Hackensack called and we have a followup appointment with them on the 25th in New Jersey. My paraprotein measures 0.3 which amounts to a Very Good Partial Response but not a complete remission. In the mean time I've developed some very acute pain in my left leg from the buttocks on down with some numbness in my toes. It may be related to Stenosis and not my Multiple Myeloma. I'm going to have an MRI as soon as they can get it scheduled to be followed by an appointment with an Orthopedic doctor where I had my knee replacement. My GP put me on steroids but they haven't had any appreciable impact. I can't lie down to sleep, so I sleep sitting up on the couch. Other than that everything is going well except I'm going to miss the annual golf outing at Pinehurst this weekend. The thought of attempting to swing a golf club makes me grimmace. The hair on my head is begining to show it's fuzzy self. Maybe it will be fully grown by the time of Amy and Kevin's wedding in May.