On Tue, Dec 4, 2012 at 10:52 PM, Mindy Reimer <mindyjreim@gmail.com> wrote:
Dear family,
Today Brad had his appointment with his oncologist, Dr. Danko. We love Dr. Danko! He is a kind and sweet man and took his time to share information and to educate us. We look forward to having him on our side during this time in our lives.
Brad has Diffuse Large B Cell Lymphoma (DLBCL). It is a common, curable, non-Hodgkins form of Lymphoma.
I want to share with you what we learned today. I know it’s hard to believe…but I don’t have a medical degree :) so don’t quote me!
Dr. Danko taught us that our white blood cells are made up of granulocytes and lymphocytes. When bacteria enters our body the lymphocytes sends off cells to attack the proteins attached to the bacteria. These cells can clone and create a clonal population of cells. When this occurs in the blood it is Leukemia. When it is the lymph system it is Lymphoma…which is again what Brad has. In non-Hodgkins lymphoma there are two grades: low grade and high grade. Low grade lymphomas progress slowly and are not curable. High grade lymphomas progress quickly, but are curable. DLBCL is a common high grade lymphoma.
There is an international Prognostic Index that helps doctors determine prognosis. It factors age(ha ha Chad, Matt and Chris :), LDH levels (an enzyme in our blood), his physical status (is he in good health), his stage in the disease, and extranodal involvement (involving more than one node).
The index is scored 0 or 1 point for each factor. Brad is less than 60 years old=0 points. We are unsure of his LDH levels…labs where done today for that, but Dr. Danko scored him 0 points. He is in good health=0 points. Lymphoma stages of cancer are figured differently from the general way that we hear stages referred to in cancer. Brad’s lymphoma is a stage IV…this meaning “multiple extranodal sites or lymph nodes and extranodal disease”=1 point. And the final factor extranodal involvement=1 point. Somewhat confusing…but overall he scores a 2 (without knowing the results of the LDH level) which gives him a prognosis of 80% survival rate. If his LDH levels are higher than normal it would change his prognosis to a 50% survival rate.
Even with all of that scientific knowledge, we are grateful to know that our Heavenly Father has a plan for us and that as we stay close to Him through prayer, covenants and the Spirit, we will continue to have peace that we are living His plan for Brad and us.
So, while around 80% of the cancer was removed during surgery, the remaining will be treated with chemotherapy. Brad will begin chemotherapy treatments on December 14th and have three more treatments every three weeks following. At the end of the first four treatments, he will have a PET/CT scan to determine the success of the treatments. If the scan is clear he will have two follow-up treatments of chemo. If the scan is not clear he will follow up with more chemo and more scans. Remission is when there are no cancer cells present. Survival or cured is when there has been 5 years of remission. We have a chemotherapy class tomorrow that will help us understand more. Also this week Brad will have a bone marrow biopsy and a port (a small medical appliance that is installed beneath the skin. A catheter connects the port to a vein. Under the skin, the port has a septum through which drugs can be injected and blood samples can be drawn many times, usually with less discomfort for the patient than a more typical "needle stick") put in his chest for easy access for the chemo.
Brad did a little research and reading last week and shared with me some of the things he had been learning. It was depressing. Even in school, I never really liked percentage rates unless it was 100% :). As I have been able to process my thoughts and feelings (as taught to me by my social working husband :) I recognize that the depressing and sad feelings that came are more about mourning the loss of our life up until a month ago. Not that from here on out, life will be bad…just different. And I mourn different. And this is a longer journey than I had at first anticipated. How grateful I am that our life before cancer though has prepared us for our life with cancer. I love the gospel. I love knowing we are children of our Heavenly Father. I love knowing of and relying on His plan. I love our Savior. I love that He gets us…that because of His atonement He understands and can comfort and give us strength. I love the Holy Ghost. That our Heavenly Father can send him to guide, comfort and teach us. And I love my B. How grateful I am to go through this experience of his with him. He is my favorite friend. I love him so much. And I get him for forever. :)
I am hoping this information helps you understand what we know and what we feel.
We love you all so much and are extremely grateful for your love for us and for your support. Heavenly Father has answered prayers in our behalf. We have felt it so powerfully.
Love you all
Brad and Mindy
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