This is a compilation of all my previous MDB Health related updates as distributed by e-mail..

Friday 7/28/06 Update on MDBest's health/treatment

Please share with others that I may have left off the distribution.

I apologize for the delay since the last update, but the last month and a half has been busy.
Again, I am in remission from my Lymphoma.
We went to the Blood & Marrow Transplant Group (BMTG) in Atlanta at NorthSide Hospital in Sandy Springs on June 19.
It was a long 4 hour visit, I took 14 pages of notes and Karin took her own.
The first hour was with a nurse who gave me general background on the types of procedures.
The next 2 hours was with Dr. Bashee, who reviewed my history, my prognosis, and described the details of a stem cell transplant.
Average remission is 4-5 years. Based on my previous disease, he does not think that I will remain in remission longer than 2 years before my cancer returns.
The last hour was with a nurse that is a transplant clinical coordinator specifically for each doctor at the center.
There are 2 types of peripheral blood stem cell transplants 1) autologus, (or auto) with your own stem cells and 2) allogenic (or allo) with a donors stem cells.
There are also bone marrow transplants and cord blood transplants that are “stem cell transplants”.
Bone marrow has the highest concentration of blood stem cells and historically most transplants have been of this type.
Umbilical cord blood is rich in blood stem cells, but the quantity is very small, often only enough for a child and often done from multiple cords. There is a lot of research in this area to make this a viable source for adults.
Peripheral blood stem cell transplants are different from the controversial fetal tissue stem cell transplants that you hear lots about in the media, often misleading.
These procedures, though constantly being refined and improved have been used for many years. I have met a man here in Savannah that had this procedure done in Savannah 15 years ago and he has been cancer free from his multiple myeloma since then.

Autologus (Auto) Stem Cell Transplant
The auto is not really a transplant in that you receive your own stem cells, but rather a high dose chemotherapy treatment with your own stem cell recovery program.
This procedure is difficult, but very surviveable, the BMTG has a perfect record to date with survivability of this procedure.
It starts with low dose chemotherapy called mobilization chemo.
Then you take injections of Growth Colony Stimulating Factor (G-CSF) for about a week that causes your bone marrow to produce an excess of stem cells into the blood. They test the blood everyday looking for a certain concentration.
Harvest is done similar to apheresis donation of platelets. They hook a needle in one arm, pump the blood through a blood cell separator that collects the stem cells and sends most of the fluid back through the other arm.
There is some quantity (in the millions) of cells that they need for transplant. Harvest may take place on multiple days until they have collected enough.
After harvest, patients undergo high dose chemotherapy that kills off any remaining cancer cells, all of your bone marrow and thus your immunity.
After the chemo, they reintroduce the stems cells and watch and wait while the immunity recovers.
Auto transplants for lymphoma are best done early, in the 1st or 2nd remission.
The cancer cells are still chemo sensitive
Bone marrow is damaged with repetitive chemo
Before the cancer has time to transform into another type of cancer
Results are better the younger the patient.
There is a chance of a cure with this procedure and high likelihood of a long remission.

Allogenic (Allo) Stem Cell Transplant
This procedure is more difficult than the auto.
It is almost a guaranteed cure if you survive the procedure and recovery.
They kill 8-12% of the patients that undergo this procedure due to complications with graft vs host diseases and damage to organs from the same.
This is not an option for me at this time with those odds.
At some day in the future, if I am much sicker, it is an option.
Siblings with the same parents have only a 25% chance that they are a suitable match for this type of transplant. I will have my brother Brad get some blood drawn and tested for HLA markers at BMTG for future reference.
There are at least 5 proteins on the surface of white blood cells, human leukocyte antigens (HLA) that are like a fingerprint.
They enable the body to know if particular cells belong in your body or not.
Siblings can be a perfect match, unrelated donors require more complicated and expensive DNA testing to determine viable matches.
I need to have myself removed from the registry before they look someday and find me as a perfect match for myself.
The chemo with the allo is much less than the auto. They don’t kill all of the immunity with drugs, but use the stem cells to actually wipe it out completely.

After the discussion with Dr. Bashey, I am a candidate for an auto transplant.
This procedure is now done as an outpatient. They used to confine patients for weeks & months.
I will have to be at the hospital daily, up to 8 hours for an estimated 6-8 weeks. It takes some patients 100 days and up to a year to be fully functional. I am hoping for the much lower end of that.
For that reason, we were planning to undertake this next summer so that Karin would be out of school. I have to have a driver to the hospital every day. I won’t be able to drive.

Stem cell transplant has been a treatment option for Lymphoma for years. Recent studies in England, published since I was diagnosed have indicated promising success in treatment for cancer like mine. Dr Negrea has met with the doctor who headed those studies since I have been seeing him for treatment. Dr Negrea refers quite a few patients to the BMTG in Atlanta. He has a very good working relationship with them. They are less expensive, have the benefit that their see patients year round and that’s all they do, and have better success rates than Emory.

I saw Dr Negrea here in Savannah at Low Country Cancer Care on July 10
He had had some extensive conversations with Dr. Bashey and they are now recommending the transplant much sooner rather than later. That was a bit of a kick in the stomach after being comfortable with the idea of preparing for this next summer.
All of the data that they have is on patients just through with a treatment and in remission, not later in remission prior to relapse.
We will likely initiate this beginning the week of Labor day.
He thinks that I have a chance for a cure with this treatment. Cure is a word they don’t use much in discussion of Folicular Lymphoma.
Dr Negrea’s office works well with the BMTG and they will allow me to do a barrage of pre-treatment testing (cat scan, bone marrow biopsy, etc.) here in Savannah at the end of August that will avoid an extra round trip to Atlanta.
I met a patient of Dr Negrea who had a similar transplant at the same center in Atlanta for his Hodgkin’s Disease. He told me a lot of the gory details that they may not tell me about. I hope to meet with him sometime to learn much more as I prepare for this.
Dr. Negrea has had a patient return to Savannah in as little as 4 weeks. We will hope for that.
I am scheduled for vacation the week of 8/6-12. I will keep Bennett during Karin’s days back at school in pre-planning. Her folks will be in Maine that week on vacation.
I will see Dr. Negrea again that week.
Karin’s dad Paul will be here Sunday 8/13 to keep Bennett during the day as Karin starts back to School 8/14. He will be here until we have to go to Atlanta for treatment.
We will move to Atlanta and stay with Karin’s parents for the duration of the treatment. They live in the Stone Mountain area. It is not the most convenient (drivewise & traffic depending on time of day) to Sandy Springs, but they will help with Bennett each day while we’re at the hospital.
The following start is tentative. It could shift a week. We will probably go to Atlanta for me to have education, a physical, and testing the Thursday following Labor day (9/7).
I will do the mobilization chemo on Wednesday (9/13).
I’m not sure if we/I will be back to Savannah any after the process is initiated, but maybe.
Somewhere along the way I have to have a triple lumen catheter implanted in my chest in a vein to my heart. This will protrude from my chest unlike the portacath I have now under my skin. The portacath is not big enough in diameter. I will have this for ~30 days. I’ll have to invest in plastic wrap to keep the port and site clean and dry.
After the mobilization chemo, I’ll give myself Neupogen (the G-CSF) injections in the stomach for 5 days or so.
I’ll have blood checked everyday. Once the concentration of stem cells is high enough, they’ll start the harvest.
They will do flow cytometry studied on the cells to make sure that there are no abnormal cells.
After there is enough stem cells for the recovery, they will start the high dose chemo.
I think this will be for about a week. It will be worse than all of the chemo I had to date combined much over.
I’ll have all of the crappy side effects from chemo that I mostly avoided with the Rituxin CHOP treatments.
The will continue to check my blood daily.
My immunity will drop off to zero. There is a serious risk of infection.
I will check my temperature around the clock and keep a journal of all my side effects that might indicate infection.
I will have to have units of blood and blood products until mine restarts. I will have to take meds to grow white & red cells.
I’ll probably have to wear a mask and avoid crowds for a while.
Please don’t send any flowers. I’ll have to avoid them and plants and dirt as they are full of bacteria that your immune system protects you from.
I’ll have to be extremely careful and eat only fully cooked foods. Raw vegetables & fruits have the bacteria like plants.
I am going to buy a laptop this weekend. I’ll figure out and set up a web page or blog prior to treatment so that I can keep you updated more frequently and informally.
I am in good health today and I feel very good.
I wish that there was more time to prepare physically. I had planned to work out and exercise more to be in better shape to better handle the treatment next summer, but there will be little time for that.
I am very disappointed that I will likely miss my 20th high school class reunion in October. I was looking very forward to that. Thanks to all of you who have been keeping in touch.
The next month or so will be very busy. We have to get all the insurance and leave set up and approved. We have to take care of a lot of details. I have to get the house re-roofed before we leave.
Karin will be off work on leave of absence without pay for whatever time this takes. She will start school before we leave and hopefully retain her slot when she returns. Thankfully I have good short term leave coverage.
We have a friend from church that will stay in our house while we are gone.
Bennett is doing well. He was 9 months yesterday. He weighs ~25 lbs. He became very mobile in the last 2 weeks. He’s now a handful as we are not completely baby proof yet.
Many have asked about pictures. I’ll update you as things firm up.
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Friday 6/15/06 Update on MDBest's health/treatment

Please share with others that I may have left off the distribution.

PET-CT scan yesterday, went fine.
Big news today, PET-CT results, I am in remission.
I still have a mass (4.8X 3.3 cm) by my left kidney compared to (16 X 13 cm) on a previous exam, but there was no FDG (Radioactive sugar) accumulation in the mass. (i.e. no cancer).
There are no other enlarged lymph nodes in my head, neck, adomen, or pelvis.
We will stop Bio & Chemo treatment at this point.
My Oncologist said that for years that they would worry with trying to get the mass (treated diseased tissue) to zero, but that would beat me up.
My blood is puny, but not seriously low. My white count is the lowest it has been in 15 weeks.
The cancer that I had, for most patients, comes back repeatedly, and can mutate into a worse form.
We will go to Atlanta tomorrow and I have an appointment at the Georgia Blood & Marrow Transplant Group on Monday at NorthSide hospital in Sandy Springs. I will learn more about a stem cell transplant for long term remission.
Either my oncologist (Dr. Negrea) or the folks in Atlanta will do a bone marrow biopsy to see if it is clean.
I am scheduled to see Dr. Negrea July 10.
Apart from a stem cell transplant, going forward, I will likely do repeats of the Rituxin (biological therapy) every 6 months for 4 weeks in a row.
Thank you for all of your support and caring.

Mark
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Monday 6/6/06 Update on MDBest's health/treatment

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Bennett and I bachelored it overnight for a week. Most nights were fine, a few were a little crazy with sleep schedules.
Marie joined Paul Wilson (Karin’s Parents) here for the week to help out with Bennett and me. They were a tremendous help. I can’t thank them enough.
Last Friday (6/2) was my 6th treatment of 8 scheduled.
Marie took me to treatment and stayed with me for the morning. My friend Kenny Hill joined me for lunch and took me home afterward. Thanks so much to the both of them.
I am still doing pretty well, but the treatments are starting to beat up my bone marrow and my white blood counts have been low for the last 2 tests. Hopefully they will be in range by this Friday with the steroids. I miss eating fresh fruits & veggies.
Tests on my liver function do not indicate any impacts from the treatments. That is good.
Sunday, I participated in an event sponsored by the Oncology Nurses in the area “Runway to Recovery”. There were 30+ other cancer survivors & patients. I was humbled talking to the others and hearing their stories, learning the things that they have had to go through. I’ve had it very mild compared to many that I met.
I go to Atlanta on Monday June 19th to the Georgia Blood & Marrow Transplant Group at Northside hospital in Sandy Springs to learn about a stem cell transplant. This is a possible option for me that can offer a probable long term cure/remission for my Lymphoma.
On Thursday June 22nd I will have another PET-CT scan to stage my cancer. If I get lucky, we’ll stop treatment where we are now.
Friday, June 23rd is my 7th scheduled treatment.
A friend from church, Bob Hastie, who sadly just recently lost his dear wife Jill to Breast Cancer is sailing in the Volvo Cup, Lukemia & Lymphoma Regatta in my honor.
Thanks to those that have brought meals for my family: Brittany Robinson, Alice Wood, Sheila Vibert, Tom Tucker, and others that I may have forgotten.
Thanks to all who have sent cards, books, CD’s, movie passes, gift certificates, etc.
Thanks for your caring and your prayers.

Mark
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Thursday 5/11/06

Please copy those that I may have omitted. Tomorrow, Friday May 12 is Biological and Chemo treatment number 5 of 8 scheduled. Tomorrow night through Saturday morning is the American Cancer Society Relay for life. Thanks to those that have sponsored me for relay and for the March of Dimes WalkAmerica.

I handled the last treatment cycle better than the previous one. No major mouth problems or extreme fatigue. I've been taking some additional herbal supplements that my friend Michelley in Memphis sent. I hope to continue as well with the remaining cycles. I pushed Bennett in the jog stroller for the WalkAmerica (April 29), 6.2 miles and did quite well in just over an hour. We smoked most of the other walkers. My daily walks have me in better shape than I have been in for quite a while.

Its not too late to sponsor us for the Relay for Life. See the attached from my wife and my friend Kenny Hill. See the attached pictures. We'll do nearly anything for a good cause. You can reach me by pager (912) 239-2023. Catch me today at work, or join us at the walk at BC Friday night. My cell phone (912) 898-8909. Karin's (912) 398-4060. Kenny's is in the attachment also. Feel free to call us during the walk that starts at 6 PM and continues to 9 AM Saturday.

Thanks for all of your caring and support.

Mark

How about that??? We're gearing up for the relay and Kenny thought this up at the last minute!!! What a hoot! I've even gotten one sponsor for Mark's head, AAction Air here on Wilmington Island! They'll all be sooooooo cute with ads on their clean heads for the walk.
Mark will undergo treatment number 5 on Friday prior to the Relay! He feels great and thinks that he'll be able to stay out all night long. I've convinced him to be honest about how he feels and we will come home if he gets too tired. I'll be sure to update you all after the treatment and the walk. Stayed tuned for photos and an update.
Thanks for all of your continued support!
Love, Karin, Mark and Bennett


From Kenny Hill
Date: Wed, 10 May 2006

Hi, y'all. Most of you know Joe, Steve, Royce and I shaved our heads almost two months ago in support of Mark's battle with cancer. We have formed a Relay for Life team: Five Bald Men and a Baby (Mark & Karin's son Bennett)! We will be on the track at Benedictine this (all) Friday night and are raising funds as well as awareness for cancer research.

Now the fun part... You can buy space on our freshly-shaved heads for a message of support, your name, your company name, logo, whatever (clean, please) statement you want to make!

Come out to the track between 6pm and 6am this Friday-Saturday and purchase your space on site so you can scribe on our heads yourself! Call Kenny at the Relay (912-596-6184) to make the connection. You may also send your message, name or logo (jpeg) via email (kenny@riverstreetsavannah.com) and we'll embellish our heads with temporary color tattoos! Please designate the name of your big-headed billboard person: Mark, Joe, Steve, Royce or Kenny. We will be glad to arrange payment delivery/pick-up or honor your pledge to be mailed.

Suggested Cranial Real Estate per square inch: $25.00
Suggested Color Tattoo Logo per square inch: $100.00
Any donations are of course welcome!
All checks should be made payable to the American Cancer Society (ACA), Memo: 5 Bald Men & a Baby

It's all in good fun and humor, but carries with it the seriousness and impact that cancer has on all our lives. Your support will help fund a cure!

My bald best,
Kenny
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Thursday 4/20/06 update on MDB’s health 4/20/06

Please share with others that I may have left off the distribution.

· Tomorrow (4/21) will be my 4th chemo & biological therapy session (scheduled for 8 sessions).
· This third round has been more unpleasant than the first two.
· I had a week of significant fatigue (the second week following treatment). My red blood count was good, so there was no anemia to explain the tiredness.
· Along with the fatigue I had really crappy mouth condition with sores and very sore gums. Thats a catch 22 because you need to floss & brush much more than regularly during chemo to keep from getting infections, but it was almost too sore to do it regularly
· My white blood count cycle has remained the same. Good at one week post treatment, and just below target the at two weeks post for the cells that fight bacterial infections. I have to cut out fresh fruits & vegetables, deli meats, buffets etc. for about a week around that test and only eat things that are cooked well.
· My appetite has remained good, and I've gained back alot of the weight that I lost. All of my dress shirts are very loose in the collar now.
· 3 days after the 3rd treatment I had a CAT scan, that indicated the progress of mostly the first two treatments. I can't interpret all of the radiologists lingo, but it was generally good. Most of the lymph nodes in my chest & thorax have cleared up. The big tumor between my left kidney and lung has shrunk 50-70%. There is still a good ways to go, but this is very encouraging.
· My blood pressure is back in the normal range and I've discontinued my BP meds. This is most likely due to the tumor no longer pressing on my kidney.
· I rarely have any heartburn & reflux anymore, but I will take antacids when I am on the steroids to avoid some side-effects associated with them.
· Bennett is growing up fast. He will be 6 months next Thursday and he is growing out of his 9 months clothes. He will be mobile pretty soon.
· I have an appointment in June in Atlanta with the Blood and Marrow Transplant Group of Georgia to learn more about a possible stem cell transplant. My oncologist is strongly encouraging this a longer term remission treatment.
· Bennett is growing up fast. He will be 6 months next Thursday and he is growing out of his 9 months clothes. He will be mobile pretty soon. He is keeping Karin and I and my father in law (Paul) very busy.
· I continue to try to walk 30 minutes daily.
· Thanks to all of you for your encouragement, cards, food, calls, prayers and well wishes.

Mark
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Friday 3/24/2006 update on MDB's health 3/24/06

Please feel free to copy others that I have omitted.

Things are going very well so far with my treatment and recovery. I have 2 of 8 treatments behind me. The biological and chemo treatment have been mostly uneventful so far. I have some minor side effects (mouth problems, aches, no hair). I've put back on a little weight. I'm still trying to walk 30 minutes every evening. I'm sleeping very well. My white blood count today was a little low 3.6 vs a 4.0 lower limit, and it is the specific portion that fights biological infections that is low, so I have to be cautious about what I eat, hand washing, etc for the next few days. The white counts are higher than at the same point after my first treatment. All of the other blood counts are good.

My 3rd treatment is scheduled for next Friday (3/31). Sometime after the next treatment I will have another PET-ct scan to see how much the tumors have been shrunken-eliminated.

My oncologist is interested in me investigating a stem cell transplant after my treatment is complete. He had a discussion recently with one of the world's top Lymphoma specialists from the oldest hospital in England (don't recall his name at this minute, but I have seen some of his work published). New research indicates that a stem cell transplant can offer a much longer if not permanent remission for some lymphoma patients after completing biological therapy & chemo.

I have 4 good friends who have joined me with the Lt. Theo Kojak look. Three of them had their heads shaved Wednesday night. Attached is a picture. I'm the tall one if you can’t tell us apart.



Thanks to all for the continued support and encouragement.

Mark
(912) 238-6172
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Friday 3/3/2006 Update on MDB 2nd week into treatment

I'll keep this brief:
Week 2 post treatment has been rather good.
Generally I feel very good. I'm trying to figure out now how long I had been feeling not good prior to starting treatment, it has been quite a while.
I continue to walk 30 minutes each evening. I have some random joint pains from the tumors breaking down, and the walking generally makes it better.
I've lost a bunch of weight ~ 20#.
I have a good appetite and I'm eating 3 full meals, snacks and desserts.
I have not lost my taste, but it is as though my tongue has been partially burned with hot food, if you know that feeling.
My blood pressure is still a bit high, so I'm still on meds for that.
The Savannah pollen is aggravating my allergies, and I'm starting to get a sinus infection. I got a Rx today for antibiotics to work on that.
My blood tests today were all good, except my white blood count is too low. I have to be cautious of infections, avoid sick people, not eat raw foods, etc.
Hopefully all will be back in line in time for treatment #2 next Friday 3/10, and I'll be 25% done with the treatments.
Bennett is growing fast and keeping us busy. At his 4 month check up Tuesday, the pediatrician congratulated us on our healthy 9 month old (20#, 6 1/2 oz., 27 1/2" tall).


Thanks for all of your well wishes & prayers.

Mark

Please share with those that I have not copied.
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Friday 2/24/02006 Update on MDB 1 week into treatment

Friends and Coworkers,

Treatment Day (2/17) - a long day 9:15 to 4:30, hooked to various IV’s connected to my chest port.
~20 min into the Rituxan infusion, I got very tight chested and short of breath. Rather scary. They stopped for 20 min, then gave me a shot of Benadryl and I proceeded through the 3 bags & 1 injection with no other problems.
All of the nurses and staff were great.
All of the other patients (6-10 various during the day) were great support and very encouraging.
It could have been very depressing, but it wasn’t. The facility is brand new, comfortable and nicely put together. Karin stayed with me except while getting lunch for me and filling my prescriptions.
Today (2/24) it has been 1 week since starting my treatment, and things have been generally very good.
I have had no nausea, vomiting, diarrhea or constipation.
Today I had my blood counts checked and all is in pretty good shape. My white blood count, red blood count & hemoglobin are at the lower end of normal range – where they were before I started treatment. i.e., I should be out of the woods for worry about major infections etc. My platelet count is good and has increased since before treatment.
I have a low grade fever since last night, so I am taking some Tylenol.
I am walking 30 minutes each evening when I get home from work. I have some ached in my joints, likely from the tumors breaking down to uric acid and trying to collect in my joints. I take allopurinol for the first month to keep from getting gout.
All of my days have been good (5 with the benefit of high dose steroids), with the exception of yesterday evening. Last night my back, stomach, ribs and kidneys felt like I had been beaten.
I have some moderate mouth/tastebud issues, but I haven’t lost my taste and will continue to take care of my mouth as best that I can.
I’ll probably cut my hair short next week as it will likely fall out in 1-2 weeks.
I can breathe normally now without any pain. My blood oxygen levels are normal now.
I have been able to sleep in a bed on my back since this past weekend. That is tremendous for me and for Karin.
I can eat normally. I have a good appetite, and I have only limited heartburn.
I have lost 13+ lbs since starting treatment, mostly from loss of tumor mass. I lost some additional weight prior to treatment due to lack of eating and lack of Miller High Life.
My blood pressure has reduced significantly, 100/70 yesterday from a high of 158/116, so they cut my blood pressure medicine in half, and I hope to be off of it soon. It dries me out excessively.
I will have my blood checked again next Friday, and will have my second treatment Friday 3/10.
I will be treated if all goes as planned until mid-July, that is a long way to go, and I’m sure there will be some lousy times ahead, but I am very encouraged at this point.
Bennett will be 4 months old on Monday, and I am looking forward to taking him to the pediatrician on Tuesday. (We’ve confirmed that none of his immunizations are live virus type, so I should be OK with those).

Thanks for all of your caring, encouragement, cards, calls, well wishes and prayers. Feel free to share this with others that I have omitted.

Mark
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Wednesday 2/15/2006 Update on MDB's health/treatment

feel free to share this with others that I may have omitted.

Friends and Coworkers,
I am scheduled to begin my treatment on Friday (2/17).
This will be an all day event 6-8 hrs.
My Oncologist is George Negrea, my treatments will be in his office at the new Nancy N. & J. C. Lewis Cancer Care & Research Pavilion across Reynolds street from Candler Hospital in Savannah.
I had a good second opinion consultation with Dr. Goldberg. He is in good agreement with the course of treatment.
Both Oncologists expect that I will have noticeable relief from pain/discomfort in 2-3 days following the start of treatment.
The cancer I have is Indolent (slow growing) Follicular B-Cell (type of Non-Hodgkins) Lymphoma.
I have likely had it for years.
The PET-CT showed involvement in my lymph system from my kidney level up to my esophagus.
It is stage 4 due to being present below and above my diaphragm and in my bone marrow.
The bone marrow tests show that I have 30-50% involvement in my marrow, which was suspected by my Oncologist based on slowness of this disease combined with its advanced stage.
The large mass (between my left kidney and lung) is pressing on and collapsing my left lung making it difficult to breathe.
The pressing on my kidney and various major veins has raised my blood pressure significantly.
I can only eat small meals due to my stomach being compressed/displaced. I have frequent terrible heartburn often when I eat in moderation.
My course of treatment is called Rituxan CHOP.
I will receive 8 treatments at 21 day intervals initially (this will last into mid-July or August).
That will be followed at 6 month intervals of 4 Rituxan treatments 1 week apart. I'm not sure how long the maintenance will continue after that.
Rituxan is a monoclonal antibody that binds to a particular protein - the CD20 antigen - on the surface of normal and malignant B-cells. It then recruits the body's natural defenses to attack and kill the marked b-cells.
My cancer cells test positive for CD20.
Stem cells (B-cell precursors) in bone marrow lack the CD20 antigen, allowing health B-cells to regenerate after treatment
This combined treatment has been successful for many patients. The Rituxan therapy on top of the CHOP chemo has increased survival and decreased recurrence significantly.
The chemotherapy is called CHOP (C-Cyclophosphamide, H-Doxorubicin (Adriamycin), O-Vincristine (Oncovin), and P-Prednisone).
I will take the Prednisone (a strong steroid) for ~5 days following each treatment, I understand that things can get pretty crappy once I come off the Prednisone.
I will play it as it comes, but I will be at work as much as possible, it helps me keep my mind busy.
My hair will all fall out in a few weeks, so I'll probably cut it short ahead of time to lessen the mess and the stress of it all falling out at once.
Due to the fact that this cancer is slow growing (i.e. lots of it is turned off at any one time) it will be difficult to eliminate it down to the molecular level.
There is a chance that it will recur by the 7-8 year mark post treatment, but the Rituxan maintenance therapy makes that less likely.
It may come back in a similar form, but there is a chance (10%) that it will mutate and come back as an aggressive form.
The side effects from the treatment will be lousy, but
I am looking forward to being able to breathe normally and be without pain.
I am looking forward to being able to sleep in a bed on my back or however I please.
I am looking forward to being able to eat more normally.

Thanks for your understanding, caring, encouragement, well wishes and prayers.
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Wednesday 2/1/2006 FYI on MDBest's health

This is to a pretty wide distribution to co-workers and friends. Feel free to pass this on to others that I may have omitted. I want to make you aware of my heath situation. A few of you already know that this has been developing.

I have been feeling poorly since the week following Christmas. Daytimes at work are generally fine, but nighttime has been bad. I cannot sleep in a bed or lying down, only in a chair, reclined a bit. I have significant abdominal pains from time to time.
2 weeks ago I was given a preliminary diagnosis of possible Lymphoma based a CAT scan. The largest mass is some 8" by 6.5" by 5".
Yesterday it was confirmed that I have cancer of my lymph system - a diagnosis of Follicular Lymphoma from my surgeon based on the Pathology examination of a gland he took from my neck last Friday. This is non-Hodgkins type Lymphoma.
I will have surgery tomorrow (Thursday 2/2) to implant a port in my chest for chemotherapy.
I will meet with my Oncologist on Friday to go over the details of the PET-CT scan from last Thursday and to outline where we go from here regarding diagnosis and treatment. From the Oncologist's PA, the preliminary from the PET-CT was that both my chest and abdomen are affected and it is extensive.
They will do biopsies on Friday from both my hips for bone marrow to see if it has been affected.
My heart is in good condition for chemo based on the ECHO test last Thursday.
I hope to be medically treating this next week.

That's what I know for now. I plan to continue to work and to fight this. I'm sure that I will be off from time to time depending on my treatment cycle. Karin and I are extremely stressed , but Bennett (3 months) is keeping us grounded. We have help from both sets of our parents and many friends.


Keep me in your thoughts and prayers,

Mark