The Next Step

Wow! I can't believe we're nearing the end of January already. The past month has been a weird one in the world of Josh, but I still found time to redesign the blog! January has been full of chemotherapy and uncertainty about what's yet to come. After another PET/CT scan (see 'Being Scanned' for more details about this), the medical team have come to a decision about what will happen next. Here goes.

Apparently I have responded well to ESHAP chemotherapy and we are ready to go ahead with a stem cell transplant!

This is where it all gets very complicated and I will do my best to explain it. I can't guarantee everything will be completely accurate though, as it's such a complex procedure. 

Nothing ever explains my feelings better than the Simpsons can.
Let's start with the reason somebody would need a stem cell transplant. It's a common misconception that the transplant is the part of the therapy that will cure the patient. This is not the case. The important procedure comes a week before the actual transplant. It involves a special chemotherapy combination called BEAM and it is one of the most intense regimes available. This should be harsh enough to destroy any residual or remaining cancer cells. Unfortunately, the chemotherapy is so strong that the bone marrow is also destroyed. It is impossible to survive without bone marrow and the stem cell transplant is actually a way of managing this serious side effect. Complicated, huh? 
Not this kind of BEAM, unfortunately...
The next stage is deciding where these stem cells come from. In many cases, a donor from the Anthony Nolan Register is required (UK only...). In other cases, a patient may provide their own stem cells, but these must be collected when in remission to avoid transplanting cancerous cells back in.

After long deliberation, my medical team have agreed I appear to be in remission! This means I am eligible for an autograft transplant. In normal terms, I am a suitable candidate to use my own stem cells. One benefit of this is that there is almost no chance of my body rejecting the cells as they are my own. Another is that recovery time is more rapid, as the body accepts the cells more readily.
This is my cringeworthy "You Can Do It!" motivational face.
And that concludes my current knowledge of the next step! I shall be meeting with the Transplant Coordinator very shortly and then I will know the preparations required before the transplant, as well as the how long the whole thing will take. Watch this space...

Joshua Lerner

Hi! I’m the 'star' of Livin' With Lymphoma. The blog was founded on the 31st October 2013, on the day I was diagnosed with Stage 4B Hodgkin's lymphoma. I hope you find it funny and informative.

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  1. Wow nicely explained Josh, nice and simple and makes total sense. It was explained to me by a friend who's Mother had stem cell transplant, yours is clearer. Good luck!