Wednesday, December 07, 2005

DICE kicked ass, but the high-dose is ready to nuke it!



Yesterday afternoon I had a PET-CT scan at the hospital. The PET-CT scan is an imaging test used to provide pictures of the inside of the body. It's significant because the test can evaluate with great sensitivity the activity and extent of an illness. It's a common test used in evaluating Hodgkin's Disease. My oncologist, therefore, scheduled this exam last week in order to determine the results of the 2 cycles of DICE that I have received.

The last PET-CT I took was back in early September at around the time that I learned I would need to undergo treatment again to deal with this recurrence. This scan revealed the presence of cancer in the same area as it was back in 2003: the mediastinum (the area between the lungs). In addition to the mediastinum, the exam showed suspicious activity in my tonsils. Under further examination, the slight activity in the tonicles was proven inconclusive. If the cancer had spread to the tonicles (which would not be uncommon since lymph nodes are present in the neck), I was told that the high-dose chemotherapy that I'd receive prior to the stem cell transplant would wipe out whatever malignant cells were there. So the scan that I took yesterday was the first tangible way of knowing what magic the DICE treatment had done since then.

As soon as I returned home from the hospital late yesterday afternoon, the phone rang. It was the physician assistant (PA) from my oncologist's office. She said that she had received the preliminary results of the PET-CT scan. I, of course, was surprised because I didn't expect to find out the results until I met my oncologist again on 12/15. She then went on to tell me that according to the exam, my tumor was gone. It's gone? Uhh, yeah it's gone! As you may imagine, at first I didn't quite understand the enormity of what she had just told me. For at least a few minutes, I was grappling mentally with what she had just said. I can best describe my reaction as something akin to a tape delay. The signal was sent by the transmitter, but it took a few seconds before it was picked up clearly and processed by the receiver. As the PA explained the results to me, I nodded and expressed satisfaction but really I was just "doing the motions." It took me a couple of minutes before I began to grasp what I had just learned.


The PA told me that although the results were preliminary, she didn't expect the final report to differ. This was the best possible outcome that we could have hoped for from the DICE she said. Indeed, I thought that perhaps some or a part of the tumor would be zapped away but I didn't expect this. Damn, the DICE kicked serious ass! Well, as my father explained something was bound to happen if one is infused like I was with a strong regimen of chemotherapy 24 hours constantly for 4 consecutive days. While I ate, I received chemo. While I slept, I received chemo. While I went to the bathroom, I received chemo. While I watched tv, I received chemo. Indeed, there were no breaks.

What yesterday's news means is that my body reacted very well to the DICE regimen and that in addition, I tolerated it pretty well. The physician assistant explained to me that these are good signs that the course of treatment will continue to work well. Despite the success of the DICE, the stem cell transplant remains necessary. I was told that the research shows that even after having received remission (as in my case now), there's still a chance that the cancer can stage a comeback. Perhaps there are microscopic malignant traces of the cancer still present that were undetectable by the PET-CT scan. I, of course, don't want a rematch with Hodgkin's. Twice is enough. I'm going for a TKO. The transplant, she said, offers the best possible chance at a cure and therefore, life-long remission. I didn't come this far to bail out now, so I say, "Let's bring it on!"

I'm very happy with the results of the DICE regimen. I achieved remission, which is honestly more than I imagined at this stage in the treatment. Damn, the DICE kicked ass! However, I have been down this route before not with DICE but with ABVD (the chemotherapy regimen I received during my first go-a-round). I achieved remission then but our nemesis came back, so at the same time I'm pleased with yesterday's news I'm a bit timid to claim victory quite yet. In fact, I'm a little uneasy about using the word "remission" to describe my situation. I'm fearful that it might be a bit premature. My opponent is down on the mat with its arms and legs spread out, but is it down for good? Will the referee reach the count of 10 before it can get up again and take another shot at me?


The rules of war dictate that a fair and proportional response must be applied to the threat at hand. Hodgkin's doesn't seem like it was too much of a fight for its battle with the DICE, but before it has any chance of mustering a counter offensive, I say nuke it! Nuke the tumor! Nuke it for once and for all. And that's exactly what the high-dose chemotherapy is aimed to do. The high-dose chemo is really the star of this play, but the DICE's remarkable performance seems to have robbed it of some of its expected spotlight. The high-dose is what I like to refer to as the silver bullet. It's the high-dose chemotherapy (which is a much stronger chemo regimen than the DICE) not the transplant that's supposed to nuke the cancer away for good.

My mom credits yesterday's great news to the benevolence of the Almighty. Jesus is still in the healing business she says faithfully. My mom knows though that I lack the faith to believe, but despite that she continues to encourage me to put my trust in Him. In fact, she tells me that one day, when she's in Glory, I'll have a testimonial to make. It will be a testimonial about the goodness of God that I'll be able to make from my own experience with cancer.

She became very emotional after learning about my news yesterday. She cried as she told her brother and sisters over the telephone about the great news. Her tears and cries weren't of sadness, I'm sure, but rather of relief and thanksgiving. Even I as her son and as the patient don't really know the gravity of what she as a mother is feeling and how much Tuesday's news meant to her. I can imagine only. I know this entire experience has been very difficult for her, but yesterday's news is a promising sign of even better news to come.

6 Comments:

Comment Anonymous Anonymous said...

we are all in your cheering court and and are thrilled with the good news.
keep up the good work!
EFG and your Chapin fans

6:14 PM  
Comment Anonymous Anonymous said...

I'm so happy to hear that! Congrats! We're cheering for you in Chi-town!

Sarah, Scott, and the rest of the gang.

11:45 PM  
Comment Anonymous Anonymous said...

Awesome, awesome awesome!!! I am so glad to hear the news. I have talked with so many people who have undergone a transplant and to go into remission before the transplant is a wonderful sign of success!!!! I am so happy for you Duane. I know you dont want to count your lucky stars yet and I truly dont balme you but this is really great news! I hope you are smiling really big inside because I am!!!

- Tianna

11:02 AM  
Comment Anonymous Anonymous said...

This blogger thing is soo unique to me, but then I'm soo old. The idea to write about your condition, to express your feelings, and to hopefully help someone else is to say the least about your character. Duane words cannot express how happy I am for you and your family to hear such good news. Looks like you can kick ---, and nuke the sucker at the same time. Muriel Watkins

6:59 PM  
Comment Anonymous Anonymous said...

What good news for you, your parents and all concerned! Maybe your mom is right and Someone is in the back row, cheering for you in the ring with the rest of the crowd.

9:03 PM  
Comment Blogger Duane said...

Wow. Thanks for the comments everyone. Yes, I'm really thrilled about the Tuesday's news. It's amazing. I'm just preparing myself for the next phase now.

11:28 AM  

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