General Update

 

From Paul:

Cycle 3 (in Waiting)

We are waiting on complete healing of Doris’ skin punch biopsy before Cycle 3, which includes another infusion, and the reintroduction of the oral medication and adding a second oral medication will again be part of her treatment. For now, her treatment continues to be on pause until the healing is complete.

I am going to attempt to present the medications (without naming them) and the desired effects they will have in treating Doris’ MCL. I am leaving the names of the medications out because I don’t think I know enough to give medical advice.

If you are less curious than I am, you may want to gloss over much of what follows. I would suggest you could skip to the heading "Skip to here".

Doris began Oral Medication (OM-1) on May 29. It is an antineoplastic agent (cancer medicine). Antineoplastic refers to substances or treatments that inhibit or prevent the development, growth, or proliferation of neoplasms, which are abnormal growths, such as tumors, that can be cancerous. OM-1 interferes with the growth of cancer cells, which are eventually destroyed by the body.

The graphics and descriptions below indicate the typical cell functionality, a cancer cell that is resisting apoptosis, and the restored apoptosis that results form the introduction of oral medication OM-2.

OM-1 has been shown to block 100% of BTK in blood cells and 94% to 100% of BTK in lymph nodes when taken at the recommended total daily dose.

Bruton’s tyrosine kinase (BTK) is a protein that has been linked to MCL.

Doris began infusions with Infusion Medication IM-1 on May 29 as well. It is a monoclonal antibody that binds to the CD20 protein on B cells, which are one type of white blood cell. B cells promote the production of antibodies, which are part of your immune system. Cancer cells typically have higher levels of CD20 proteins than healthy cells.

IM-1 triggers an immune response when it binds to CD20. The drug-attached cells are attacked by and killed by signals that are sent out. Cancer cell death can also be commanded by IM-1.

Doris will begin using Oral Medcation 2 (OM-2) when Cycle 3 begins. OM-2 is an antineoplastic agent (cancer medicine). It interferes with the growth of cancer cells, which are eventually destroyed by the body. 

When normal cells are old or damaged, your body triggers them to self‑destruct. This process is called apoptosis (ay‑pop‑toh‑sis). In some of my study, I learned that apoptosis is a routine occurrence in our bodies, including the the early development stages of all humans. For example the webbing between our fingers is eliminated by apoptosis during fetal development. Cells that are no longer functioning are generally targeted by our bodies to be eliminated. They go through a self-destruct cycle, and then they are eliminated from our bodies through our body’s filtering and cleansing processes.

I hope it helps you to see these schematic representations as much as it helped me. I like to visualize the process and understand what needs to happen for this treatment to find success.

In certain types of cancer, there is too much of a protein called BCL‑2. BCL‑2 blocks the cell from triggering apoptosis. When this happens, cancer cells do not self‑destruct as they naturally would, and they build up in the body.

 

 

OM-2 targets BCL‑2 proteins and attaches to them. When OM-2 is attached to these proteins, it helps to restore the process of apoptosis, allowing these cells to self‑destruct because the apoptosis triggers are no longer blocked by the BCL-2 proteins.

 

Skip to here

Our waiting takes on a new meaning this week. Regardless of the cause of the pause, we are still waiting. Waiting can be difficult when we want to be getting on with something. However, in our most recent visit with Doris’ hematologist, he referenced the fact that her treatment began in the early stages of the cancer, and as such waiting for continued treatment will not affect the treatment in the long term. Instead of being impatient, it helps to continue our attitude of waiting on the Lord. It is His will that will prevail. Consistent with the counsel of our Prophet, President Russell M. Nelson, we recognize that all things on which we wait, for which we pray and exercise our faith are dependent on the will of God. We want God to prevail in our lives. While we feel assurances of the successful treatment and the outcomes of that treatment, we trust that God knows the end from the beginning, and we are grateful that we have a loving Heavenly Father. This is the “but if not” part of our hope. We have confidence in God that Doris will receive the healing necessary that she may have full remission or healing from this cancer. “But if not,” we will continue to trust in Him from Whom all blessings flow.

Praise God, from whom all blessings flow;

Praise him, all creatures here below;

Praise him above, ye heav’nly host;

Praise Father, Son, and Holy Ghost.

From Doris:

Waiting

Although I am grateful for a temporary reprieve from my cancer treatments, I have rediscovered how hard it is to wait. As I wait for treatments to resume, my two-year treatment regimen continues to lengthen. Not knowing when it will end makes it difficult to plan our family’s 2027 reunion. 

 Waiting is part of learning patience. As a patient I have to sit in a waiting room. Isn’t there a different word that could be used for this holding location? Is it really necessary to remind me that I am waiting?  The room is packed with people, each waiting to hear his/her name called.  Will the news be good?  Will the treatment be tolerable?

 There is a different kind of waiting that I am trying to learn.  This one is not simply measuring the passing of time.  It was described by Robert D. Hales in the June 2015 Ensign Magazine.

 “The purpose of our life on earth is to grow, develop, and be strengthened through our own experiences. How do we do this? The scriptures give us an answer in one simple phrase: we “wait upon the Lord” 

 

Isaiah 40:31

31 But they that wait upon the Lord shall renew their strength⁠; they shall mount up with wings as eagles⁠; they shall run⁠, and not be weary; and they shall walk, and not faint.

 What does it mean to wait upon the Lord? In the scriptures, the word wait means to hope, to anticipate, and to trust. To hope and trust in the Lord requires faith, patience, humility, meekness, long-suffering, keeping the commandments, and enduring to the end.

 Our son Andrew shared with me that the words for wait and hope in Spanish come from the same root word: esperar. This week I am going to focus on hope as I spend more time as a patient in the waiting room.