Good Blood, Bad Blood

I have multiple myeloma, a cancer that affects the plasma cells in my blood. The initial diagnosis occurred in December of 2007. So, it’s been four years and seven months. My first doctor gave me five years to live; the second opinion I received generously offered six years. In retrospect, both those prognoses seem pessimistic. I plan to be around longer than originally expected.

As of June 21, 2012, it has been one thousand three hundred and ninety four days since I underwent an autologous stem cell transplant at the Seattle Cancer Care Alliance. Following that high-dose chemotherapy, I enjoyed a drug holiday for 30 months.

In January of 2011, my doctor prescribed revlimid, an immunomodulatory drug, to counteract renewed activity in my cancer. Last fall, we agreed to add the steroid, dexamethasone, to my treatment. The theory behind drug “cocktails” suggests that as the cancer finds a pathway around one drug, it is held in check by the other, which targets a different aspect of the malignant cells.

Recently, I heard a comment from an individual who is dealing with a serious development in his cancer. The disease had metastasized, spreading beyond its source. His story is a cascading series of bad news, week after week. The prognosis is grim. Yet, tongue in cheek, he pleaded, “I’m tired of having cancer. Can I please have something else?”

Those of us with cancer have a right to protest. The complaining helps us cope. For even when favorable circumstances exist, such as I enjoy, cancer can still be an exhausting companion. Siddhartha Mukherjee explains the problem in an article from The New York Times Magazine titled, The Cancer Sleeper Cell. “In a cancer cell, ____ the accelerators of growth are jammed permanently on, the brakes permanently off. The result is a cell that does not know how to stop growing.”

For me, the nuisance factor keeps demanding my attention. My eyes, my energy level, and my feet trouble me. Because the cancer remains relatively stable, I take these changes in stride. I can even rationalize the reality of living with an incurable disease. I might argue that my body is assailed by age as much as malignancy. I’m 65 and though my eyesight is decent, the dry irritated chronic condition that I blame on the steroids, also comes with the territory of my seventh decade. The same might be said of my wavering energy.

Younger patients, of course, find it more difficult to account for their bodies’ reactions to multiple myeloma. The little debilities accrue to an extent that justifies a more aggressive treatment protocol. Tandem transplants, for example, may be better tolerated among those under the age of 50. Furthermore, such a therapy could extend remissions until better, perhaps even curative, treatments are developed.

At my age, I prefer counter-punching to an all out assault. The maintenance therapy of low dose rev/dex affords me a high quality of life. Yes, I take lots of naps and squint when the wind blows. But, overall, I enjoy my favorite things.

Last night, a drenching rain teased me with summer’s arrival. At dawn, steam rose from the smoldering earth. An ascendant sun crept above the horizon, maximizing its hold on the night’s territory. Outside my front door, a mother grouse scuttled across the grass. Her tail feathers stood upright in full defensive array. Before her, five chicks hustled, obedient to the sound of her clucking.

Spring arrived and departed; summer begins just as the days start their long slow decline. Wildlife has passed the birth cycle and now nurtures its young. My home, still unsold, offers me a serene environment in which to indulge in reading, writing and gardening. In closing, here are three books I recommend: State of Wonder, by Ann Patchett; Canada, by Richard Ford; and The Cat’s Table by Michael Onaadjte.

Enjoy.