Monday I wrote an article about a research study, presented at ASCO titled, Is It Time to Abandon Up-Front Transplantation in Multiple Myeloma?
Here is a comment I recieved from a reader who calls himself “J” the next day:
Pat, there is no answer yet for this question. I am so glad I did transplant. Two years, no drugs, no side affects, living a life that has better quality than in years. Still in CR. My treatment plan is to exercise(running and keeping at an ideal weight). I take no vitamins or supplements, as they stress my kidneys, which are almost back to normal function. I feel great!. If there was just some way to test how the response would be ahead of transplant that would be ideal…but I don’t see that in the cards. There is just so much difference between a high and low risk MM. Mine is low risk, so my medical plan does not work on the high risk patient.
“J” is not alone. As a matter of fact, a majority of patients who endured the inconvenience and side effects associated with a stem cell transplant (SCT) feel the same way.
Many of you who have read my book, Living with Multiple Myeloma, and/or read this site regularly know I chose to have my stem cells collected and stored—and then postponed my SCT. I have even developed a reputation for being “anti-transplant.” Nothing could be farther from the truth.
I have pushed back hard against using SCT’s as an initial standard of care because I feel patients today have several, less invasive options to consider before starting induction and then moving blindly to SCT.
I have received a number of “thank yous” from readers over the years who didn’t realize they had a choice. Their doctors never presented waiting as an option—or if they did, it was in a cynical or condescending way. Thanks to the experiences of thousands of patients like me—as well as studies like the one I wrote about on Monday—I think some of these attitudes have started to change.
I have been called the “hero” of the anti-transplant movement. I hate to disappoint my readers who think of me in this way, but after over three years on Revlimid, I am beginning to seriously consider undergoing my first SCT later this year.
Stop the presses! (Does anyone even say that anymore?) Hold the phone! (Another saying which may soon become a dinosaur!) Pat seriously considering a stem cell transplant? Sure! Why not? I never claimed they were a bad idea—just not the be-all and end-all when there were other new, less invasive options available.
I want to pause here to reassure my readers this is still a theoretical argument for me—an academic exercise I want to share, hoping it will help some of you who are facing similar treatment decisions. After all, after five months my M-spike is currently holding at a barely measurable .3. My myeloma is moving so slowly I have no reason to expect much, if any change when I visit my oncologist again in August.
But it will return—that much is certain. More about my posible options, and why I am leaning toward undergoing my first SCT tomorrow. Thanks for reading! Feel good and keep smiling! Pat