Nashville or Bust

The trip that started a longer journey


Last week, some of you may have spied this tweet of mine. It was at the end of the day and I had been doing some related medical research for a work project. The opportunity to skate around the University of Nebraska website was there so I took it. I wanted to shake answers out of the sky … and my laptop.

As unhealthy as that exploit felt at the time, it seemed to work. Dr. Chan and his team literally were faxing the report to Dave’s doctor as I was boring holes into my screen. Yesterday when Dave went in for his check-up and treatment #3, he finally received a full pathology report. In black and white. With little paragraphs, circles and arrows to boot.

The good news is that it is not one of the ‘Terrible Ts’ or any sort of ‘Undifferentiated Neoplasm’ — things we had heard thrown around in the past. They have also ruled out plasmablastic and any T-Cell forms of Lymphoma — directions seemingly plausible from the quickie path study conducted in the OR. The words on the paper brought us back to our starting place of Diffuse Large B-Cell Lymphoma. And while that may seem ironic … especially after everything Dave had to go through to get there… there is a (see comment) comment attached. It’s always something…

Dave’s “challenging” case is “very difficult to classify” due to an “atypical morphology and immunnophenotype of tumor cells.” I’d argue that all of this is an atypical morphology, but then again, I’m the girl with the Google Med School degree, remember? Basically, their report says they’ve never seen anything like this. So, behind the base clinical category are the words “not otherwise specified.” Dandy. While this may seem unnerving, it is the consensus of a group of doctors who have pioneered many advances in Lymphoma treatment. A very large group of doctors. Dave’s slides were actually presented at a conference, thus the delay. We imagine PowerPoint was involved as well as some sort of buzz-in and vote mechanism. Had we known, we would have tagged his pictures ‘rights managed,’ negotiated a nice per use fee and sent popcorn. Not that Nebraska needs corn sent to them. That’s our Kentucky hospitality (and odd humor) kicking in.

Back to more good news … the CHOP chemotherapy that Dave has been receiving (and received yesterday) is the best course of action for this type of unclassified classification. The only rub is that one of his markers, CD20, is negative so that prevents him from receiving Rituxan as part of his therapy. I was somewhat hoping that this additional weapon could be added but it looks like he has to go old school. Dave was terrific in getting through treatment even when his veins didn’t want to cooperate in the beginning. (They were cold.) He’s become very good around needles and the nurses really are the sweetest. He’s an amazing guy and such a good sport.

Originally we were told six to eight rounds of chemo then we’d talk some radiation. We’re still on that track. Dave will get a CT scan right before his next treatment so his doctor can evaluate tumor response. We know the tumor didn’t like round one of the sinister cocktail and that was a VERY ENCOURAGING hurdle to overcome. We can’t wait to see how much more these additional rounds have beat it up. We are also going to conference with another physician in his oncology group to see if Dave will be a contender for additional forms of treatment. Given his no words can describe it situation, a little more exploration is warranted. His case has their attention. As it should.

All of this will take place in Cincinnati on either side of the New Year so we’ll be able to get through the holidays in comfort, ringing in cheer and hope. Spring and the finish line will be even closer at that point. *yay*

P.S. — I know many of you were waiting on this news yesterday. Sorry to shove you in the waiting room, as that place is a cave. Yesterday was a big day and perhaps it was the cold, but the events took more out of me than I expected. Sleep was good for my head (and this post) as I was able to channel some perspective. Thanks for the continued prayers, thoughts and hugs. The support is amazing and so very appreciated.~ Jacqui


December 14, 2010 Posted by | Dave | 6 Comments