Monday, April 28, 2008

Lymphoma Treatments

One of the most important characteristics of being a caregiver is being optimistic. I must admit it is not always easy. Finding encouraging articles such as the one below gives me and my husband much hope. We also believe every word of the Bible and cling to its promises especially in a time like this. The Bible says, "A merry heart doeth good like a medicine: but a broken spirit drieth the bones," Proverbs 17:22. The Lord tells me through His Word that if I am happy it will make me better. He also tells me that a broken spirit can kill me. My husband, whose lymphoma is now in remission, often tells me that he guards his spirit. Perhaps this is what will keep the lymphoma in remission.

New Lymphoma Therapies Targets Diverse And Difficult Cancer
ScienceDaily (Apr. 28, 2008) - The fifth leading cause of cancer in
the United States, lymphoma is made up of more than 40 rare and
highly diverse diseases that target the body's lymphatic system.
Lymphomas include both one of the fastest growing cancers --
Burkitt's lymphoma, which can double in size in as little as a day --
and one of the slowest, chronic lymphocytic leukemia (CLL).

While all lymphoma types can be cured or managed as a chronic
disease, its complexity and variation do not allow for a one-size-
fits-all treatment approach. Instead, it necessitates highly
specialized and individualized approaches.

With a dozen new therapies in development -- one of the largest
portfolios of lymphoma drugs under development anywhere -- the
Herbert Irving Comprehensive Cancer Center of NewYork-Presbyteria n
Hospital and Columbia University Medical Center is meeting this
challenge with highly effective new treatments for the disease,
giving hope to the more than one million lymphoma patients worldwide.

In 2006, NewYork-Presbyteria n/Columbia recruited Dr. Owen A.
O'Connor, one of the world's top lymphoma researchers, to lead its
Lymphoid Development and Malignancy Program, and direct more than 25
full-time scientists and physician scientists.

"By increasing the number and quality of treatment options for
lymphoma patients, we are improving their chances for survival. This
is especially critical for patients who haven't responded to standard
therapies," says Dr. O'Connor, who is also chief of the Lymphoma
Service at NewYork-Presbyteria n/Columbia and associate professor of
medicine at Columbia University College of Physicians and Surgeons.

One of the most promising new therapies developed at NewYork-
Presbyterian/ Columbia is PDX (pralatrexate) for T-cell lymphoma --
among the most fatal forms of the disease. The drug is uniquely
designed to camouflage itself as a folic acid, which allows it to be
absorbed by the tumor, where it attacks the cancer. The therapy has
been shown effective in 54 percent of patients who did not respond to
other treatments. The drug is now being evaluated around the world,
and if its activity is confirmed, it may get regulatory approval some
time next year.

"Our hope is that the national multi-center clinical trial that is
currently underway to evaluate this drug will result in an improved
treatment option for patients," says Dr. O'Connor, who has played a
leading role in developing the drug.

Researchers are also exploring novel lymphoma treatments that are not
chemotherapies. These include drugs targeting Bcl-6, a gene cloned by
Dr. Riccardo Dalla-Favera in 1993, and an enzyme known as histone
deacetylase. Work by Dr. Dalla-Favera has shown that drugs affecting
these two targets will markedly synergize with conventional
chemotherapy, and may lower the amount of chemotherapy necessary to
achieve remission.

"We are very excited about the promise of these new therapies. Our
lymphoma program includes some of the nation's brightest scientists
working together to translate laboratory discoveries into improved
treatment options for patients," says Dr. Dalla-Favera, who is
director of the Herbert Irving Comprehensive Cancer Center at NewYork-
Presbyterian/ Columbia, director of the Institute of Cancer Genetics
at Columbia University Medical Center and Uris Professor of Pathology
and Genetics & Development at Columbia University College of
Physicians and Surgeons.

Investigators at NewYork-Presbyteria n/Columbia also collaborate with
colleagues at NewYork-Presbyteria n Hospital/Weill Cornell Medical
Center, including Dr. John Leonard.


Friday, April 25, 2008

The Lord Will Strengthen Thee


Watching my husband go through cancer and the treatments is the most difficult thing that I have ever experienced in my life. I want to make all things better, but it is impossible. Only God can accomplish that.

Day after day I look for encouragement that comes from friends and family. My friends and family do so much to make life easier for us at such a time as this. I know that God has them in our lives for this very purpose.

Day after day I yearn for my God to give me the assurance that my husband will be totally healed. He speaks to me through HIS Word (the Bible). Today the Lord encouraged me with the Bible verses written on the top of this article. My husband's blood counts at this time are very low (requiring blood transfusions), but the Lord "will strengthen him upon the bed of languishing" and "thou wilt make all his bed in his sickness." The best part of these verses is "The Lord will preserve him, and keep him alive." The Lord is in control of life and death and could choose to take my husband home to Heaven tonight. But for now HE encourages me by telling me through his Word that HE will keep him alive (at least for now) and he will comfort my husband by making his bed. Everything is okay for today. I must live one day at a time and not fear what tomorrow may bring.

Monday, April 21, 2008

God Will Be With You

"When thou passest through the waters, I will be with thee; and through the rivers, they shall not overflow thee: when thou walkest through the fire, thou shalt not be burned; neither shall the flame kindle upon thee," Isaiah 43:2

All the responsibilities of a caregiver can be exhausting so I hear. At this time, I don't feel exhausted; however, I have had times of fever, aches, and pain, wondering if I would be well enough to care for my husband. Those fevers, aches, and pains did pass. Praise God!!

If you have read my first post, you would know that a stem cell transplant and months of recovery are in our near future. It's like a tornado is heading straight for us and we can do nothing to stop it. But we can pray that the damage is minimal.

A Christian "shalt not be burned" when he/she walks through the fire. The Lord says "I will be with thee" when we walk through the waters and that "they shalt not overflow thee". What a promise! Why should I worry or fret?

Cancer or any other illness is not a good thing, but it does offer the caregiver and/or patient positive aspects:

1. A closer relationship with God
2. More trust in God
3. A chance for others to see our faith in action
4. A faith purified by testing

Friday, April 18, 2008

A Possible Cure for Mantle Cell Lymphoma

The following article is encouraging to me because my husband has mantle cell lymphoma. According to my husband's oncologist, the doctor (Dr. Christian Geisler) referred to in this article pronounces his name like we do ours. Interesting!!

Intensive Regimen May be Curative in Mantle Cell Lymphoma
Zosia Chustecka
Information from Industry

Find out how inhibiting multiple signaling pathways may result in a dual-action antiproliferative and antiangiogenic effect. Learn more

December 19, 2007 (Atlanta) — Results obtained with an intensive immunotherapy regimen in mantle-cell lymphoma are so good that they suggest that a cure is in sight, said Christian Geisler, MD, PhD, from Rigshospitalet, in Copenhagen, Denmark. He was presenting the results of a 160-patient phase 2 study from the Nordic Lymphoma Group here at the American Society of Hematology 49th Annual Meeting and Exposition.
However, 1 member of the audience took exception to the use of the word "cure," and an expert in mantle-cell lymphoma told Medscape Oncology that the results are interesting but it is still too early to draw conclusions.
Dr. Geisler explained that mantle-cell lymphoma is a rare subtype of lymph cancer, representing about 10% of all lymphoma, and has one of the worst prognoses, with half of patients dying within 3 to 4 years of the diagnosis, even after treatment with anthracyclines. "Until now, it has been considered incurable," he added.
In an attempt to improve outcomes, the Nordic group devised an intensive treatment regimen. Patients first underwent 6 cycles of intensive induction immunochemotherapy with a combination of high-dose cytarabine (ara-C), the anti-B-cell antibody rituximab, and dose-intensified CHOP chemotherapy, known as "maxi-CHOP," which comprised cyclophosphamide 1200 mg/m2, doxorubicin 75 mg/m2, and vincristine 2 mg on day 1, followed by prednisone 100 mg on days 1 to 5. After this, patients went on to receive high-dose chemotherapy with stem-cell support.
"We achieved results that were quite surprising to all of us," Dr. Geisler commented at a press briefing. "The long-term disease-free survival was 63%, and after 3 years we saw a plateau in the survival curve, indicating for the first time that this disease may be cured." Investigation with polymerase chain reaction (PCR) showed that the "majority of patients after transplant do not house any tumor cells," he added. Toxicity is "quite mild," he commented. There were 6 treatment-related deaths (3.8%), which compares with what is seen with chemotherapy and stem-cell support.
On an intention-to-treat basis, the 5-year event-free survival was 63%, the overall survival was 74%, and the 144 responders (91%) who completed treatment had a 72% 5-year response duration, with a plateau emerging in all 3 curves at these levels, Dr. Geisler told the meeting. "Compared with historic controls, we can now say that a cure is in sight," he said.
Asked to comment on the findings, Owen O'Connor, MD PhD, from Columbia University, in New York, said that it is still too early to draw conclusions. "For us to be fully convinced, we need to see more mature data," he commented in an interview. Dr. Owen also noted that not all patients in the trial went on to receive a stem-cell transplant, only those who responded to the initial intensive regimen did, so there was some attrition. Although the response rate was 96%, the rate of complete remission was only 55%, which is "a little weird for me," he said.
The prognosis for mantle-cell lymphoma has improved in recent years, Dr. Owen explained, and the survival of 3 to 4 years that is still cited in the literature is based on studies carried out during the early 1990s. "We are now managing it better," he said. The use of ritiximab (launched in 1998) and a move toward carrying out stem-cell transplantation at first remission rather than at relapse plus, even more recently, the use of bortezomib, has led to improved outcomes. "There is a sense that the median survival is now closer to 5 years and may be even better," he said in an interview. There are several groups showing good data, and 1 group, headed by Julie Vose, MD, from Nebraska Medical Center, in Omaha, has shown no relapses after 7 years.
The data from this Nordic study are "interesting," Dr. Owen concluded. In particular, the researchers' use of high-dose ara-C is "interesting and innovative," and if these results continue to stand, then maybe this is a treatment that should be explored further in mantle-cell lymphoma, he said.
The study was supported by the Danish Cancer Society and the Nordic Cancer Union. Dr. Geisler reports receiving research funding from Roche and Bayer Schering Pharma; honoraria from Bayer-Schering Pharma; and consultancy for Bayer Schering, Fresenius, and Genmab.
American Society of Hematology (ASH) 49th Annual Meeting and Exposition: Abstract LB1. Presented December 11, 2007.

Tuesday, April 15, 2008

Is Caregiving Putting Too Much Stress on You?

How can I tell if caregiving is putting too much stress on me?
If you have any of the following symptoms, caregiving may be putting too much strain on you:
1. Sleeping problems — sleeping too much or too little
2. Change in eating habits — resulting in weight gain or loss
3. Feeling tired or without energy most of the time
4. Loss of interest in activities you used to enjoy such as going out with friends, walking, or
5. Easily irritated, angered, or saddened
6. Frequent headaches, stomach aches, or other physical problems

What can I do to prevent or relieve stress?
Take care of yourself. In the process, you'll become a better caregiver. Take the following steps to make YOUR health a priority:
1. Find out about community caregiving resources.
2. Ask for and accept help.
3. Stay in touch with friends and family. Social activities can help you feel connected and
may reduce stress.
4. Find time for exercise most days of the week.
5. Prioritize, make lists and establish a daily routine.
6. Look to faith-based groups for support and help.
7. Join a support group for caregivers in your situation (like caring for a person with dementia)Many support groups can be found in the community or on the Internet.
8. See your doctor for a checkup. Talk to her about symptoms of depression or sickness you may be having.
9. Try to get enough sleep and rest.
10. Eat a healthy diet rich in fruits, vegetables, and whole grains and low in saturated fat.
11. Ask your doctor about taking a multivitamin.
12. Take one day at a time.

Sunday, April 13, 2008

Non-Hodgken Patients Living Longer: Study

March 11, 2008 (Reuters Health) -
Last Updated: 2008-03-10 16:19:59 -0400 (Reuters Health)
CHICAGO (Reuters) - Improved treatments for non-Hodgkin's lymphoma helped patients live longer in the United States, researchers said on Monday.
In particular, the targeted drug Rituxan, in combination with chemotherapy, has helped younger patients with non-Hodgkin's lymphoma, which occurs in roughly 20 of 100,000 people, they found.
Two-thirds of patients diagnosed between 2002 and 2004 will survive at least five years, compared to half of patients diagnosed between 1990 and 1992, according to the study published in the Archives of Internal Medicine.
Ten-year survival rates were projected to rise to 56 percent in patients diagnosed from 2002 to 2004, up from 39 percent in 1990-1992, the researchers found.
"Improvements were most pronounced in patients younger than 45 years, but improvements were seen in all age groups," wrote Dr. Dianne Pulte and colleagues at the German Cancer Research Center in Heidelberg, who analyzed data on nearly 86,000 patients from the U.S. National Cancer Institute.
The disease attacks the lymph nodes, spleen and other organs responsible for the body's immune system.
A key weapon against non-Hodgkin's lymphoma is the antibody therapy rituximab, sold by Genentech Inc. under the brand name Rituxan and by Roche AG in Europe as MabThera, which interferes with the growth and spread of cancer cells.
Rituxan was approved in 1997 and was the first cancer drug to use antibodies to specifically target tumors.
"Treatment with antibody therapy and chemotherapy has extended life expectancy in many cases, but whether and how often this extension represents a true cure is still unknown," Pulte wrote.
Some cancer treatments can slow the progression of the disease but do not end up helping patients live any longer. Copyright © 2008 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world

Thursday, April 10, 2008

Stem Cell Transplant Caregivers

The time is fast approaching for my husband's stem cell transplant. A stem cell transplant is a major life-changing process. The closer we get the more the medical team tells us about this process. So many things could go wrong. We are trying to dwell on the fact that this process could bring an extended remission or even a cure to the mantle cell lymphoma. Doctors in Europe are starting to call the stem cell transplant a cure for this disease.

My husband has not required extensive care from me as of today, but I hear and have read that this will change. "In reality, caring for someone having a BMT (Bone marrow /stem cell transplant) is a unique commitment requiring extraordinary physical and emotional effort. The primary medical focus, of course, is directly on the patient, the hope for a positive treatment outcome. However, like the patient, the challenge of a BMT for the caregiver becomes life changing as well. "--Myra Jacobs & Mary Horowitz, MD.

For almost 29 years now I have loved and yes even liked my husband. He is my best friend. God has given us a wonderful marriage. Without this love and dedication I have for him, I don't think that I would be able to endure what is about to invade our lives. My responsibility will not be a casual one, but one that is a serious and ongoing promise. Soon I will become coach, nurse, nutritionist, aid, driver, administrative assistant, advocate, and more. My duties will go on for weeks, months, or a year. No matter how long or how challenging it is clearly worth the effort for a man that has loved me and that I love with all my heart.

"O man greatly beloved, fear not: peace be unto thee, be strong, yea, be strong. And when he had spoken unto me, I was strengthened, and said, Let my lord speak; for thou hast strengthened me, " Daniel 10:19.

Tuesday, April 8, 2008

The Spirit and Bravery of Cancer Patients

People say, oh I could never do that! But when you meet cancer patients you understand the bravery and spirit those people show each and every day. The struggles motivate and inspire you to test the limits of your endurance and to cross that finish line. You'll be surprised by what you can do.--John Kellonyi (8-time marathoner and leading fundraiser with The Leukemia & Lymphoma Society's Team in Training)

Monday, April 7, 2008

An Encouraging Story from an Encouraging Man

God has allowed me to correspond online with Daryl Sprague. Mr. Sprague has authored a book that I think would be helpful to you or a loved one going through a serious illness. He has had the same type of stem cell transplant that my husband is about to have. You may purchase his book or ebook online at:

Product description
Once Was Not Enough-A Story of Hope in the Heartland by Daryl Sprague
"Do you find yourself questioning something that happened in your life? In Once Was Not Enough, author Daryl Sprague tells how he coped with life after being diagnosed with non-Hodgkin’s lymphoma. This heart wrenching story of hope, for a cancer survivor who endured multiple recurrences of cancer, tells how Daryl dealt with his feelings of desperation. Daryl said, “Each recurrence brought with it unique lessons that helped me understand why Once Was Not Enough.” This page turner tells about Daryl’s hope, and how his faith in God actually got him through the hard times of chemotherapy, and hearing the dreaded news about recurrence. Even a person that doesn’t believe in God will find this story very encouraging. Being a long-term cancer survivor has given this author a definite perspective on the important things in his life."
324 pages - $22.99 (paperback)

This item usually ships within 5 to 7 days.
This book is also available for purchase as an eBook download.
Welcome to the world of eBooks where instead of receiving a physical paper book in the mail, you would be given access to the eBook file for this complete book. Within minutes you can be reading this book on your computer, PDA, cellphone or a stand-alone eBook reader (such as the Sony Reader)—at a reduced cost! Click the "Order Online" button below to purchase this eBook download today!
$13.99 (digital download)

Sunday, April 6, 2008

Giving Thanks

“In every thing give thanks: for this is the will of God in Christ Jesus concerning you,” I Thess. 5:18. The Bible tells us to give thanks “in every thing”. Yes, even in mantle cell lymphoma am I to give thanks. God has a purpose in this situation that seems hopeless. Yes, even in your situation whatever it may be God wants you to give thanks.
While in the valleys of our lives we can truly get to know Jesus more. Sometimes in our so-called “normal” lives we are blinded to what really is important. When stricken with a serious illness it really doesn’t matter whether you have the latest fashions. Remodeling your home isn’t so important either. All that matters is that you or your loved one is healed.
Illness causes us to muse more than when our life was “normal”; hence, causing us to see so many others that have a far more critical situation than we have. We conclude that we don’t really have it so bad after all. That is one reason to give thanks.
Another reason to give thanks is that we live in America. Although we don’t have a perfect healthcare system, we have a great one. Some countries don’t even have sanitary hospitals or clinics much less the modern diagnostic equipment that we have. For the most part, we have health care professionals that genuinely care for the well-being of their patients.
Going through serious illness also gives us a chance to reflect on our lives and make any changes that we need to better serve our Lord. “And I will bring the third part through the fire, and will refine them as silver is refined, and will try them as gold is tried; they shall call on my name, and I will hear them: I will say, It is my people; and they shall say, The Lord is my God,” Zechariah 13:9. When silver or gold is heated up it becomes more pure or precious. When God allows the “fire” to refine his people they become more precious. Of course, becoming more precious or pure is for the purpose of being used more of God.
So we can thank God that HE will use us more for HIS glory. My husband and I’s desire is that people see Jesus in us while we are going through the valley of mantle cell lymphoma and when we are on the mountaintop once again. We shall come forth as gold if we allow God to use us.
Focusing on the greatness of God causes me to thank HIM for everything. There are so many other reasons to give thanks and I may be writing about some others in the future, but for now I just want to say “Thank God for mantle cell lymphoma”.

Becoming a caregiver

In December 2007 Charlie, my husband, was diagnosed with stage IV mantle cell lymphoma. The only clue that anything was wrong with him was painless lumps in his arms, neck, near an ear, and armpits. Prior to being diagnosed two different doctors told Charlie that the lumps were just fatty masses. The lumps near his ear caused his jaw to dislocate. He was diagnosed with TMJ at that point. Finally, in early December a different doctor ordered a CT scan that showed extensive probable lymphoma. The next business day he saw an oncologist that just upon examining him knew that he had lymphoma. Further diagnostic tests including a bone marrow biopsy affirmed the diagnosis of mantle cell lymphoma.
On December 17, 2007 Charlie began chemo treatments. Each treatment requires days in the hospital with about a two week break between. Mantle cell lymphoma is a very aggressive, stubborn lymphoma that requires aggressive, strong chemo treatments followed by a stem cell transplant after 6-8 chemo treatments.
On March 24, 2008 Charlie had his own stem cells harvested and frozen for later en-grafting. The stem cell transplant should occur in April. At this time he will be given very strong chemo that will wipe out his bone marrow. Charlie’s immune system will be very low at this point. This is when he especially needs prayer. The hospital stay should be from 3-5 weeks long if there are no complications.
Stem cell harvesting was not at all what we expected. After reading all the literature, we got the idea that it might cause a bit of flu-like symptoms. The growth factor injections caused Charlie’s white blood count to go as high as 87.8 which was considered critical. Previous to giving himself these injections he took steroids which caused a water weight gain of about 10 pounds. The growth factor injections added another 10 pounds of water weight. This made Charlie miserable.
Another side effect was an irregular heartbeat with discomfort in the chest. A troponin blood-test was abnormal and so was an EKG. A day or so after the growth factor injections were stopped the EKG was normal and so was Charlie’s heartbeats. His oncologist believes that all of this was caused because of the growth factor injections, but the cardiologist at the hospital wants to give him an ECHO test to be certain that there is no heart disease.
Charlie’s oncologist wanted to harvest about 5 million stem cells, but settled for 2.5 million after just 2 days of harvesting. Charlie produced about 1.56 million on the first day of harvesting and only about 1 million on the second day. The oncologist said that due to the intensive chemo that he has received, he would not have been able to produce many stem cells on the third day. She says that 2.5 million stem cells will be more than enough for en-grafting.
Harvesting took two days. On the third day the catheter was taken out and blood tests were taken to make sure that blood counts were safe. The blood counts were okay with the exception of the platelet count being low and the white blood count being high. The oncologist also wanted to make sure that another EKG was normal before he was allowed to go home.
Two days later, Charlie’s platelet count was only 47, only a bit higher than two days ago. His oncologist wants the count to be to at least 100 before she begins his 6th round of chemo. We expect the platelet count to be up to 100 by early week which means that the final chemo treatment before the stem cell transplant will be this coming week.
So far, Charlie has not experienced any long term pain or tiredness from the chemo treatments. But the stem cell harvesting really surprised us with extreme tiredness and weakness. This was the most challenging step of the journey for both Charlie and I.