1927 / Class of '83 / Type: Solitary Plasmacytoma progressing to Myeloma / Surgery, chemo, long-term remission / Updated: 3/04
It's times like this that a person wishes he had kept a diary. I'll try to give you a run-down from the get-go to give you a history of my cancer. If you have any questions I'll be glad to answer them if I can. I'm a little cloudy on some of the dates but I'll do the best I can.
It all began in September 1981 when I lifted a heavy object at work and got this terrible pain in my back and flanks. This was misdiagnosed as a compression fracture of a vertebra and was treated with muscle relaxants and analgesics. After a week in the hospital and two more at home in bed I returned to work. I continued to have some small amount of pain but took aspirin and muscle relaxants for it.
Late in 1982 I began to have terrible pain again, mostly in my flanks, very little in my back. I put up with it until I could hardly walk and finally, early in 1983 I went to an orthopedist who suspected a "plasmacytoma" on my spine. He explained that this was an indication that cancer was present. He referred me to the University of Arkansas Medical Center in Little Rock. At this time I was unable to get out of bed so I went to Little Rock on a mattress in the back of our station wagon.
The doctors in Little Rock, after a battery of tests, including bone marrow test, and a biopsy to confirm the plasmacytoma, diagnosed the Multiple Myeloma. The first step, they said, was to do something about my back. So, they spent 11 or 12 hours inside of me, scooping the plasmacytoma out which removed most of the vertebra. They had to leave some of the plasmacytoma that was too near the spinal cord. They then removed bone from my left hip bone and grafted it in the place. They also inserted two steel "Harrington Rods" and attached them to the vertebrae above and below to stabilize my back while the graft was growing. They then molded a plastic body brace that reached from my neck down to my crotch.
After a few weeks I returned by ambulance to St. Edward Hospital in Fort Smith and was under the care of my orthopedic doctor and an oncologist. The oncologist did very little at that time because I was still recuperating from the surgery.
Altogether I was in the two hospitals for six or seven weeks. A few days before being discharged from the hospital I started a series of radiation treatments on the spinal area. This was to take care of the plasmacytoma that they were unable to remove. After I got home I continued the radiation for a total of 23 treatments with a linear accelerator. I had a lot of nausea from this and some diarrhea but I didn't get any burns from it. One rough part about this was that I was still bedfast and had to go to the clinic on a mattress in the station wagon, then sit and wait. Meanwhile I was also in the body brace.
After five months I finally returned to work. Still in the brace. Fortunately I had a desk job and a great boss. At first I only worked a few hours a day, then half a day. When I started on full days I would lock my office door at noon and lie down on the carpet for a restful lunch hour.
At this point I guess the Multiple Myeloma had not manifested itself in my system to cause a need for treatment. At first they ran blood tests every three weeks. Among this test were those for protein serum and electrophoresis. They said they were "watching" the cancer. After a while they started stretching the time between tests until finally they were making them every six months.
1985: After about two years a test showed a drastic elevation in my protein level. The graph he showed me indicated a level of about 1200. They then, however, had to send a test away to a lab out of state to determine what protein count was elevated. It seems that only one kind of protein is an indicator for Multiple Myeloma.
When the test result came back it was positive for Multiple Myeloma. The doctor said there were options. He said some doctors would recommend starting treatment right away and others would say to do nothing until I began showing symptoms, i.e., until it started making me sick in some way. (Up to this point my only problems had been recuperating from the back surgery. At some point I had been able to shuck the brace. I was feeling generally well. I had to be careful about lifting but was doing ok.) He asked me if I wanted to wait or start treatment right away. I told him I wouldn't be able to rest easy unless we were trying to treat it. He said he agreed but wanted it to be my decision.
He then said there were options in the therapy. There was the standard chemotherapy that had worked satisfactorily. I believe it was to take the therapy every two weeks for one year. Then he said there was a partially experimental "protocol" that was sponsored by the University of Arizona. This therapy called for four drugs every three weeks for eighteen months. At some point during this eighteen months' period, at the discretion of the doctor some of the drugs would be changed for a period of time to try to keep the cancer "off balance," so to speak. When I asked him if they knew whether this "protocol" was as least as good as the standard, he said they knew it was at least "better" but they hadn't been using it long enough to know how much better. I decided to go with it.
They started out with four drugs, two of which I can't recall the names. One was "Vincristine" that was given intravenously in the back of my hand. Another was Prednisone that I took in tablets for three days every three weeks. The other two were tablets taken for three days also.
After a while, I don't remember how long, he changed two of the drugs. He continued the Vincristine and Prednisone but substituted adriamycin and another drug for the other two. The adriamycin was given in his office intravenously along with the Vincristine. It was during this period of time that I lost a little of my hair. Not much. Just thinned out a little. (I was surprised because they had told me that I would lose all my hair.) After about three months he changed me back to the original four drugs and then my hair grew back to normal.
After six or eight months the doctor said that the cancer had reduced more than 50 percent and that in their profession they considered that being in remission. I continued taking these drugs for the remainder of the eighteen months.
My worst problems while taking the drugs, I think, were caused by the Prednisone. My stomach was upset a lot and my throat felt all the time as I had tried to swallow something and it didn't go down. I was pretty lethargic most of the time and just generally felt rotten. That is, except for the three days I was actually taking the Prednisone. It tended to hop me up so I felt mentally and physically high. A friend said he didn't know what I was taking but he wanted some. But boy, when I had finished taking the three day supply, I would come down off the high with a bang. Talk about feeling rotten for a few days. The folks at the office said they just tried to stay out of my way for those few days.
We are thankful for the doctors and the medical technology that was available to treat my cancer. But from the very first, our friends and loved ones were praying for me. The people at our church and many other churches were sending up prayers for me. I think that this is one reason I was able to maintain an optimistic outlook. I think that a person's attitude has a lot to do with recovery. But I know we (my wife and I) could not have made it through those rough days without those prayers.
After I finished the therapy, I continued to periodically take tests to "keep an eye on it". After a while it became only every six months and continues on until today. Only once during that time (last November) has my test shown any elevation, and only a slight one, in protein level. They had me return for further tests in January and the results were normal.
I don't think I have many ill effects from the cancer. I don't feel as good, generally, as I think I should but the doctor points out to me that my body has been through a lot. Also that I'm not getting any younger. I'll be 70 next month. If I feel any effects of the cancer now it would be that it seems that maybe I don't have the resistance to colds, flue, etc., that I should have.
After I returned to work I stayed for almost ten years. I've been retired for five and a half years and enjoyed every minute of it. I actually have more problems with my back and hip (arthritis caused from the surgery). I'm able to work around the house, make a garden and we go on a trip to Hawaii every year.
April, 2000: (Reported by a friend) Doing fine, still active in gardening and plans another trip to Hawaii this year. He has had no treatment since 1986.
November, 2003: (Reported by a friend) Still doing okay, still gets check-ups every six months. There is no indication of any Myeloma progression.
March, 2004: "I go to the oncologist every six months for my routine check up. They do several tests to check on the protein. So far the test have been just fine. I've had some problems which have nothing to do with my cancer, as far as I know. I'm doing well as far as the cancer goes. No sign of it coming back."
[Webmaster's note: This is a marvelous outcome in a patient with advanced Myeloma, including spine tumors, controlled by chemotherapy instead of transplant.]
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