Waiting for test results

Last week was the final step in Phase 3, a bone marrow biopsy. This was done in a clinic and was quick.This was the fifth biopsy Rachana had. The first two were in North hills hospital where the leukemia was diagnosed. The second one was needed because they couldn’t get a good sample in the first. The third was in UT Southwestern hospital to confirm the diagnosis before the treatment began. The fourth was after the first month of treatment to confirm her remission. Now this fifth one is to confirm that she is still in remission. So, this is a big one to make sure things are still on course! We’ll get the results on Tuesday.

Next week we are also expecting to discuss with the doctor the results from the Foundation One test. This is the genetic profiling of Rachana’s infected bone marrow from one of the early bone marrow samples before the treatment started. We received a summary line saying that she is positive for a mutation called CXCR4.  This is technical information and a simple Google search is not tell us much. So we are looking forward to hearing what this means for Rachana. The best case is the doctors don’t have to alter any treatment and there are no significant impact to the overall prognosis, which was quite positive. We’ll know this week.

Rachana was feeling ok this past week. The bone marrow biopsy was a little rough on her. The aches from the procedures have thankfully gotten better with each successive day, but it’s not all gone yet. We are hoping that her blood counts are at a satisfactory level and the first chemo of phase 4 will start this coming Tuesday. The start of this last phase will help us see the end of this journey. Although she will still have 2 years of maintenance treatment, she should be able to lead a pretty normal life at the end of this last phase, which lasts about 8 weeks. She’s already endured a rigorous 4 months of chemos and has 2 more months to go.

Over the weekend I attended a Blood Cancer Conference which was conducted by the Leukemia and Lymphoma Society. This was a good event to get information about the latest in this field and listen from a number of doctors who are leaders in this area. It was great of see Rachana’s doctors who presented sessions at this conference. One session, which was a presentation on the latest in Leukemia spoke at length about how the treatment of different Leukemia were, and still are, a ‘sledgehammer’ approach with the same set of toxic chemos given to all patients, while the exciting research that is moving more towards a targeted treatments based on genetic markers in each individual case. The doctor was saying that the first genetic profiling took about 10 years and 3 billion dollars. Now it can be done fairly quickly and costs a few thousand dollars. The doctors believe that in a generation we will be able to move away from chemo as a primary tool to tablets that target specific cells based on the genetic profile of each individual case. Rachana had to tolerate the harmful chemos, but we are still thankful that at least the doctors have much better info and confidence on what cocktail of drugs to use in the chemo for specific cancers, unlike a few decades ago where the survival rates were bad as they didn’t know much. Someday cancer will be treated with simple personalized medicines and perhaps be detected and treated using pills before it impacts someone, all based on the promise of genetic profiling and using precision targeted treatments rather than a sledge hammer.