Countdown to "CHRIS 2.0"

My parents and I went to meet my stem cell transplant doctor for the first time on Tuesday. Even though I've been dealing with the whole "cancer thing" for awhile now, the meeting felt as overwhelming as the first time I met my oncologist in 2012.

My prognostic markers are all favourable, which is great news: 

• The period of "disease control" was 2 years. This means that after my six cycles of chemo in 2012, it was nearly two years before I relapsed. Anything more than one year is good news.
• Even though I have only had one cycle so far (stupid low neutrophils) I have shown a good response to the chemo this fall. My cough is gone, my wheeze is gone, and I can't feel a tumour in my chest anymore. If I was not showing a response to this chemo, my transplant would likely fail.
• I am young and healthy. If I wasn't, the transplant could be less likely to work, or I could experience unwanted complications.

Taking all these factors into consideration, the chance of the transplant curing my cancer is somewhere between 50% and 60%. My oncologist had previously said that if the transplant doesn't work there would be other options we could explore, but the stem cell doctor expressed a much graver opinion:

"If you are not cured by the stem cell transplant, the mortality rate will unfortunately be very high."

It's very upsetting to take in something like that.

Since the meeting, I have talked to a few people who have reminded me that there are other options, that everyone is different and that I am not just "another statistic." Those things are ultimately what I believe as well, so I will continue to be strong and optimistic; however, the doctor's words are stuck in the back of my mind and probably will be for a long time.

At the meeting we also learned more about the process of my stem cell transplant. It is happening a lot quicker than I thought it would, which means I will have only one more cycle of my current chemotherapy before it begins. I was initially worried about this because the original plan was to do 3-4 cycles, but apparently my cancer does not need to be in complete remission before I do the transplant. What matters most is that my body shows a response to the chemo.

Here's a basic (tentative) outline of what's to come:

• Next week and the week after I will complete Round 2 of my GDP-R chemo at the Victoria Cancer Agency. Then I have some time to recover before my transplant.
• Starting the week of November 3rd I will need to have a bunch of vital organ tests done in Victoria. This is to make sure I don't have any major problems that could prevent me from having a safe transplant.
• On November 13th I will go back to Vancouver to meet the apheresis doctor. This is the person who will be in charge of collecting my stem cells before the transplant.
• On November 20th I will go to Vancouver again for stem cell collection. I will be hooked up to a cell separator machine via intravenous tubing. My blood will flow out of one arm to the machine where it will spin the blood around at high speed. The spinning separates the different components of the blood into layers based on their weight. The stem cell layer will then be collected and frozen for later use. The remaining blood will be returned to me via the other arm.
• On November 25th I will be admitted into Vancouver General Hospital.
• First, I have a Hickman line inserted. This is an intravenous device that is used to give fluids, blood transfusions, medications, and the stem cells during the re-infusion process. I will be given local anesthetic and a vascular surgeon will insert the line into a large vein in my chest. The intravenous tubing follows the vein all the way to my heart, and the whole thing will stay attached to me until a couple weeks after my transplant.
• On November 26th, I will begin my high dose chemo which is called BEAM. I will have infusions several times every day for six days. This chemotherapy will completely destroy my cancer. It will also destroy every blood cell in my body. Yes... every... single... blood cell.
• Within 24 hours of completing my high dose chemo, I will receive my stem cells back. This process only takes a few minutes and there isn't much to it.
• Because the high dose chemo will kill everything off, I will need to receive red blood cell transfusions and platelet transfusions. The risk of infection will be extremely high, so I may need intravenous antibiotics. As well as the usual hair loss, nausea, and vomiting I will also have mucositis, which is inflammation of the lining of the gastrointestinal tract all the way from my mouth to my derriere. Apparently this will be a real "shitty" time.
• I will then need to stay in the hospital for 2-3 weeks until my blood counts come up a bit, and I am eating and drinking and "well" enough to be discharged. I will need to stay in Vancouver for another week or so after this, because I will be going back to the hospital every couple days for follow-up tests.
• Sometime approximately 4-5 weeks after being admitted to the hospital I will be able to return home to Victoria to finish my recovery. I will be sick and fatigued anywhere from 3-6 months after my transplant, and it can take up to a year to feel completely normal again. Nah... forget that part... I'm usually pretty quick to get better! ;)
• At various points between three months and two years after my transplant, I will need to receive all my childhood vaccinations. Since the transplant is essentially a COMPLETE reset of my immune system, I will no longer have the disease immunity that I did beforehand.
• Three months after my transplant I will get a PET scan to determine if the cancer is gone. And then we will hope and pray that it NEVER COMES BACK.

To sum up: For five weeks, beginning at the end of November, I will go through a high dose chemo and stem cell transplant process that will eliminate my cancer and completely reset my immune system. By 2015 I will essentially be "CHRIS 2.0" .

And then I will have a long, tiring road to recovery.

That's a lot of writing... it's time to make dinner. Before I sign off though, I want to send out a big thank-you to my new cancer-fighting friend Samantha. She saw my story online and reached out to me when I was feeling super overwhelmed yesterday. She introduced herself on Facebook, asked for my number, and then took more than an hour of her time to pick up the phone and call me. There is nothing quite as inspiring as trading stories and sharing hopes and fears on the phone with a complete stranger. Thank-you, Samantha!!!

Christopher