Sunday, November 16, 2008

Results are in. On the size and sighs front, we'll call it M and XL, respectively. What 2 months a go was a ominous 4.3-cm boat mass is now a collective of smaller boats, together spanning around 3.2 cm. And, indeed, they're less active.

Why the M size makes for XL sighs: In order for a transplant to do the trick, the new stem cells need to be able to go into battle against a small (<2cm) boat mass, and also have as much 'surface area' as possible to be able to attack, penetrate and destroy the tumors. Imagine Navy Seals having to overtake and destroy an entire, well-armed enemy ship vs. eliminating a loosely-tied collective of rafts. (Ideally, chemo eliminates all tumor cells, enabling the transplanted stem cells to start with a clean slate in building up a completely new immune system, without the slightest recollection that tumors were ever there and with the slimmest of chances that they'd ever return.)

Why less activity matters: The bad cells won't be reproducing as quickly while the transplanted stem cells are having at them.

Next steps: It looks like I'm in for 2 encore performances (in one-month intervals), then straight into transplant -- provided a donor can be found. (The one remaining donor on the shortlist just fell through.) If there's still no donor after the chemo rounds, they may transplant back my own stem cells to tide me over until someone makes my Kim-Lucky day.

Last Friday, I went to see a doc at the clinic in Tuebingen for a 2nd opinion. He said everything done so far in Frankfurt is just what they would have done. So I got that going for me, which is nice. He'll be passing on his recommendation for next steps to my doc. Also found out about new transplant techniques that can help in case they can't find a perfect-match donor (perfect match being someone whose stem cells overlap with mine on 10 of 10 key genetic traits): With the latest machines and methods, docs can "filter out" any sub-optimal traits that could lead to complications with the transplant itself or the post-transplant side effects.

Next chemo session likely will start on Friday or the following Monday. I find out on Thu, Nov 20, in my next appointment with the chief doc of transplant center. If I don't post again then, it'll be because the next steps outlined here have held true. And I'll let this journal rest a while on this latest laurel and hearty sigh of relief.