Tuesday, June 14, 2011

The Conclusion.

Christmas 2010
While the sophisticated blood test showed myeloma cells, we didn't know what to think.  The main number we looked to as an indicator of the cancer was still as low as you can go.  Curious.

In mid December Mom seemed frail. And oddly forgetful.  She always had an excellent memory, especially for details.  Her tumour number edged up a tiny bit.  I knew then that it might be her last Christmas.

It was in those lazy days between Christmas and New Years, Mom had seemed to be coming down with a bug.  She was nauseous and very tired. I was working on a puzzle at home as we spoke on the phone. What I heard caused my heart to skip a beat.

It turns out that the fluish symptoms, and the frailty and forgetfulness were hypercalcemia, essentially calcium poisoning.  The multiple myeloma was back.  The myeloma lesions affected her bones causing calcium to leach into her blood.   A bone marrow biopsy a few days later confirmed that there were more myeloma cells in her bone marrow than there had been when she had been diagnosed two years previous.

While on a usually effective form of chemotherapy.  This was definitely not good.

The oncologist believed that her cancer morphed into something very aggressive.  He did have one new drug to try, thalidomide.  He said it might beat back the cancer well, and a patient could stay on this drug on lower doses for maintenance indefinitely.  Or it might not work and few other options would remain.

Mom started this oral chemo in January.  My Dad kept track of all her numbers and after 2 weeks of the new drug, he was keen to see some movement in the tumour marker, which had crept up since mid December.  The doctor cautioned that the blood work would likely show no improvement until after one full cycle, four weeks, and even then the movement would be gradual.

The drop was precipitous.  It dropped over a third in just two weeks.  The weeks that followed continued the trend and the numbers continued to look good through to early April.  I dared to believe that the elusive remission might be in grasp.

Then we saw a blip.

The tumour marker edged up. A tiny little bit. Since the measurement in not entirely precise, this could be an anomaly. Oh how we hoped and prayed for an anomaly.

The next week it climbed a little higher and we knew that this was not good.  But she remained on the chemo.  We  hoped the myeloma could be kept at bay a while longer.

A couple weeks later Mom's blood numbers we not good enough for her to receive the chemo.  The week following it was no better.

The doctor has some sobering news, he thought that the myeloma cells had crowded out the healthy plasma cells and that not many options remained.  There was a phase 2 clinical trial drug that might be taken on compassionate grounds.  But it was in the same family of drugs as the last two drugs that had failed.  He held out little hope.

The doctor then spoke the scariest words: three to eight weeks.

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