Wednesday, January 16, 2008

Molecular Remission

I had my regular visit with my oncologist at Dana-Farber. I was pleasantly surprised to hear the latest results of my most recent blood test. For those of you keeping notes at home, my original PCR value at diagnosis almost 2 years ago was 34.5%.

The PCR test is defined as the following from the Leukemia and Lymphoma Society Website:

The short name for a lab test called "polymerase chain reaction," a very sensitive test that can measure the presence of a blood cancer cell marker in the blood.

This meant that at diagnosis 34.5% of my blood cells showed the presence of the BCR-ABL cancer gene that produces CML. My previous reading in October 2007 showed that this number had dropped to 0.02%. This was more than a 3-log (or three fold) reduction since diagnosis.

As of December 2007 when my blood was last drawn, the number had dropped even further to 0.0038%. This is another 10-fold reduction. In total, that means a 4-log reduction since diagnosis. Although my wife thinks it is funny that I focus on these numbers, it helps to think of this in context. Otherwise, these numbers are meaningless. When you have cancer, numbers mean everything.

Upon meeting with my doctor today and reviewing the numbers, he said that he would consider me in Molecular Remission. This was essentially the last stage of remission and a huge relief. I have included a definition of molecular remission below.

Molecular response
A treatment response is called a complete molecular remission if no leukemia cells in the blood and/or marrow can be detected by PCR.

Needless to say, this is great news and I am still processing what this means. In the meantime, I can relax a little and enjoy life.

Tuesday, January 15, 2008

Role Reversal

It has been some time since my last blog entry. That is for a pretty good reason. I have not thought too much about CML or cancer for some time. Not that it ever disappears, but it is not in the forefront of my mind at all moments of the day. I am reminded when I take my pill in the morning and at night, but that is pretty much it. I am a hell of a lot more concerned about being a good father, husband, son, brother, psychologist, teacher, and business owner. If it is possible, CML has taken a seat on the back burner for the time being.

That is until tomorrow. Every few months, I am blessed with the opportunity to be thrown back into the world of cancer and visit Dana-Farber. It is not that I mind going there (not that I particularly like it either), but it is a weird role for me to be in. I spend my days at work being the provider of mental health services. I give out advice and help people deal with problems. I teach medical students how to interact with their patients and have a good bedside manner. I love being the doctor. I am a lot less comfortable being a patient. It is hard to be on the other side.

Tomorrow will be the first time that I visit Dana-Farber in several months, other than to get some blood drawn. I have not yet spoken to my oncologist about my meeting with Dr. Druker in Portland. I will also be getting the results of my most recent blood work. Although I am not too worried about this, the whole process is stressful and overwhelming at times. The only positive thing about tomorrow is that I get to spend some time alone with my wife. We have a date to the cancer unit. Fortunately, we usually go for a nice lunch afterwards.

I have also booked a plane ticket for our next trip out to Portland to visit with Dr. Druker in May. The best part is that friends we made while on vacation in Italy will be meeting us there. In other words, it will not be just a cancer trip, but a chance to relax and have some fun with friends we have not seen in a while. Actually, it will be exactly one year since we met Russ and Angela at the Vatican. Quite ironic and interesting since I am not Catholic.

I will provide more updates after tomorrow's appointment. In the meantime, here are some recent pictures of my girls from a New Year's trip to Vermont.