That’s the hope anyway. But how we get there is the question that looms before us.
In December, we got the biopsy results we were hoping for. My new cancer, my second cancer blood cancer, is an aggressive B-cell lymphoma. This is a different cancer than the one I was first diagnosed with in May. As my oncologist was quick to point out, this is the best news possible. This particular diagnosis leaves us with the most options for treatment.
But which option hinges on one critical piece. Today I had a PET scan. The results of this scan dictate which direction we move in. If the medical team sees a 50% reduction in my cancer, we move forward with an autologous stem cell transplant. If there is less than a 50% reduction my next treatment will be Car-T cell therapy.
Stem cell transplants have come a long way. In short, after my next round of chemotherapy, I would give myself a number of Grastofil injections. These injections would stimulate my bone marrow to mass produce stem cells and to pump them into my bloodstream. I would then be hooked to a machine and my blood would be filtered through it. The machine would extract my stem cells and return my blood to me. I would then undergo very intense chemotherapy for 5 consecutive days which would kill any remaining cancer along with my body’s ability to create cells. The extracted stem cells would then be returned to me and I would start the first 30 days of the healing process.
Car-T cell therapy is a relatively new therapy that turns my T-lymphocytes or T-cells into efficient cancer killers. In essence, after my next round of chemotherapy, I would be connected to a machine that will extract white blood cells from my blood. My T-cells would then be reengineered to target and fight the cancer. I would then undergo very intense chemotherapy for 5 consecutive days which would assist with killing any remaining cancer and prevent my immune system from rejecting the new cells. Once back in my body, the T-cells would identify any remaining cancer cells and latch onto the antigens. Then my cells would destroy any remaining cancer cells. This process also has a slightly shorter recovery time than a stem cell transplant. The Cleveland Clinic has a great website about the Car-T cell process if you’re keen to read more.
Both avenues will be filled with challenges and neither recovery is simple.
I asked my medical team which option has better results. The answer was not straightforward. Stem cell transplants have been around for 30 years with many trials and statistics. Car-T cell therapy is new and trials are currently underway. In Canada, a stem cell transplant is used as the second line of defence against cancer, while Car-T cell therapy is the third line. In the US, Car-T cell therapy is used as the first or second line of defence for some blood cancers.
The only question that remains to be answered is which path will we take, and which will be the road not taken.
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