On Wednesday I paid a visit to the Christiana oncologist, who concurred in all substantive respects with the conclusions and recommendations of the Hopkins oncologist. So, beginning immediately, I will once again take Revlimid three weeks out of four, unless and until testing indicates that the disease is not being restrained by the drug. Both oncologists are basing their belief that the transplant was successful primarily on the (not quite total) absence of the protein that typically shows up in the blood of myeloma patients (although in my case that signal was never particularly strong in the first place). The results of the hip bone marrow biopsy are taken as evidence that the disease has not spread, rather than saying much about whether or not it has been rolled back, since the original diagnosis was never based on such a biopsy in the first place. On such seemingly slender threads do I now teeter above the abyss.
It so happened that this week the local chapter of The Leukemia and Lymphoma Society (which also covers myeloma as a related hematological malignancy) sponsored a seminar, held at the University of Pennsylvania, explaining to patients how new treatments for these cancers are developed and approved, including the clinical trial process. So on Friday morning Huong and I traveled to Philadelphia to attend this seminar, the better to prepare ourselves for the possibility that a clinical trial could be in my future. Apparently, in spite of its relative rarity, multiple myeloma receives some pretty intense attention from the research community (the NIH's clinical trial registry has more than a thousand entries for myeloma), probably owing to its relation to the immune system, which is a very hot research topic generally. I came away from this seminar a bit more comfortable with the clinical trial concept, although I can't say that I developed any sort of enthusiasm for it, especially given the possible cost- and travel-related ramifications involved. The health-related risks I'm pretty sure I could handle.