One thing that was quickly clarified: we had in mind that the heart of the process would take 90 days. Bzzt! Wrong! That’s for allogeneic transplants, where the donor and the recipient are not the same person. Fortunately, that’s not what I’m doing. The type of transplant we’re starting up should take more like 30 days. Some take less, some take more.

It sounds like everyone is actually pretty sure that the extra radiation of my brain is a good idea. We’ll be meeting with a neuro-oncologist on Friday to check out the results of tomorrow’s MRI.

In the last week I’ve: had a physical, recounted my entire lymphoma history, declined to participate in some studies, had some blood drawn, and had my teeth examined. Coming soon: MRI, MRSA check, PET/CT, bone marrow aspiration and biopsy, and pulmonary function tests. Some of these are to make sure that the cancer is in remission, and some are to make sure I can handle the transplant conditioning.

And yesterday reminded me that when I say “the cancer is” I actually mean “both cancers are”. I met with the attending doctor for my team and he noted that stem cell transplants have been found to be curative for more aggressive cancers (like the one that was found in my nervous system), but that the slower-moving (indolent) one may still (just barely) survive.

On the plus side, indolent cancers don’t seem to develop resistance to treatment as quickly. And if they do get resistant to specific attacks, there is still a broad spectrum of treatment options. And more on the horizon.

For now it is important that the radiation and that transplant totally destroy the aggressive lymphoma. All energy toward that goal.

The message was that the initial pathology from the lymph node biopsy confirmed the bone marrow biopsy of lymphoma. They’ve sent my node (or slides from the node, or at least some part of it) to UW to have some additional stains and markers done on it for subtyping.

He invited me to schedule a phone visit for after the results are in, so I’ll do that in addition to following up with my oncologist. I really like that Dr Kent is still interested in my case, even though all the cutting is done. Additional interested experts = a happy Tom.

He says the evidence is pointing strongly toward lymphoplasmacytic lymphoma. It’s not an aggressive cancer, which is nice. But that very trait also makes it recurrent. You can treat it, most of it will go away, but it will eventually come back again and again.

It sounds like the evidence isn’t totally conclusive yet, though. He’d like to get a tissue sample from an affected lymph node, and so far the only ones we know of are in my abdomen. We’re going to do a PET scan to see if we can find any more accessible ones to remove and dissect. That PET scan isn’t until the beginning of July.

This is starting to take a long time!

Then there was a bunch of stuff that would sound gruesome if I wrote it out; he took a little bit of bone marrow, a little bit of bone, and it really hurt (but the hurt was in short bursts).

Also, my hip bone was so strong that it bent the tip of the tool he used.

Now I have a band-aid on my hip and it hurts to walk. Looking forward to a (hopefully) negative result!

After looking at everything for a little while, he offered his current 80% hunch: Hodgkin’s Lymphoma. The other 20% side of the hunch goes to some sort of currently undetected infection.

He described Hodgkin’s as being quite curable, usually after weeks or months of chemotherapy and sometimes radiation. But before doing anything like that, we first need to find out if the hunch is correct.

The prime way to find out if it’s lymphoma is to biopsy lymph nodes and bone marrow. The bone marrow is no trouble, as hip bones are nice and accessible. If he doesn’t find any cancer in the bone marrow, the next step would be to biopsy one of those abdominal lymph nodes. This gets problematic; my spleen is massive, and is in the way.

He might have to remove it.

First things first, I headed to the lab and have them perform an entire page full of blood tests. Then, in preparation for the possible removal of my spleen, I got some vaccinations for infections that can hit the spleenless hard.

Tomorrow the doctor will be in during his lunch hour to give me a bone marrow biopsy. I can hardly wait!