Mantle Cell Chemo

It's interesting that, while Michael was undergoing his initial testing, the doctor, unbeknownst to us, sent blood to an OUT OF NETWORK LAB for almost $6000 worth of tests.  Out of network means out of our pockets.  (Stay tuned - we don't know how this story will play out.)

What's more interesting than the $6000 charge is the fact that, after spending so much of our money, the oncologist came up with the standard treatment that anyone can easily read about just by searching for mantle cell lymphoma treatment.  Instead of ordering up the blood tests, I sure wish the doctor would have just asked me what chemo protocol to recommend.  I would have come off looking really smart - and I could have given a discount and still charged $4000 for it.

The usual treatment for mantle cell lymphoma is called R-CHOP.  Here are the ingredients:

• Rituximab (Rituxan), one of a special group of drugs called ‘monoclonal antibodies’. It attaches itself to a special molecule called CD20 that is present on the surface of B-cells. It is the B-cells that become cancerous in many lymphomas. By attaching to this molecule, Rituximab inactivates the cancer cells and eliminates them. As it binds only to a very specific molecule present on B-cells only, Rituximab produces no ill effects on normal cells in the body.
• Cyclophosphamide, an alkylating agent which damages DNA by binding to it and causing cross-links
• Hydroxydaunorubicin (also called doxorubicin or Adriamycin), an intercalating agent which damages DNA by inserting itself between DNA bases
• Oncovin (vincristine), which prevents cells from duplicating by binding to the protein tubulin
• Prednisone or prednisolone, which are corticosteroids. 

The drug that interests me the most is the Rituxan, since it targets a specific molecule and doesn't harm the rest of the system.  Still, it's not a happy drug.  Most people have reactions to it, so the people who administer it have to go very slowly, especially the first time, while watching for any reactions.

After reading different stories about this protocol, I know that many people will also end up having a stem cell transplant at some point.

I am hoping that Michael will get a second and third opinion from different doctors.  For a number of reasons, we are not feeling committed to the oncologist that Michael first saw.  One, he told Michael that he answers emails - even has his email address on his business card - but he has not answered the two emails Michael sent him regarding the $6000 charge.  Two, he seems to have a lot of experience with chemo, but he is not impressive when it comes to the whole picture.  Example:  Literature that we have read and the oncologist that we consulted in Boulder both say that exercise every day is a must, but Michael's oncologist just said, "Sure. You can exercise."  Does he care about the patient's health or does he just administer chemo drugs?

Michael still wants to avoid chemo, but the way things are set up in this system, I think we need an oncologist in order to monitor the disease (I hesitate to call this a "disease" when Michael feels so disease-free).

Day nine of our home gigong practice and it's only getting better!