Two Doctors...Two Opinions

This afternoon Dave and I headed to The James Cancer Hospital for what would be our second opinion. We assumed that she would have a different perspective than Dr. Kuebler, but we didn't expect her theories to be quite so different.

Dr. Kristi Blum is young, aggressive, and to the point. Typically, my kinda girl. However, the variables change a bit when we are discussing the man I love. Upon entering the room, she gave Dave a thorough examination. She felt swollen lymph nodes in places the other doctors had not. Although I would like to believe that she has no idea what she's doing...she sure seemed pretty confident. I should also add that she isn't just an oncologist...she is an oncologist with a specialty in Non-Hodgkins Lymphoma.

She said at this point she could tell Dave was at least in Stage 3, Grade 1, Non-Hodgkins, Follicular Lymphoma. Say that three times fast! She also added that 95% of people with this diagnosis find out they are in Stage 4 with infected bone marrow as well. Of course, we won't know any of this until next week when Dave has his full body CT scan and bone marrow biopsy. She went on to tell us that the swollen nodes are fairly large in his groin...3-4 cm each. The sizes will also be verified by the CT scan.

So...here we are again. Except now we are 66 days away from the arrival of Marshall instead of 73! We begin to talk treatment. I'm expecting her to say...let's take the "Wait and See" approach as Dr. Kuebler suggested. Apparently these two doctors don't bounce ideas off each other at happy hour because their ideas for Dave's treatment are very different. Although she says she does often times take the "Wait and See" approach, she doesn't like to do it with young patients. She spoke to the fact that cancers in general, but specifically Lymphoma, tend to be more aggressive in younger patients and that therefore, we need to be more aggressive in our treatment as well. She told us that based on her gut feelings, he would need treatment in 3-6 months. Obviously very different from Dr. Kuebler's..."it could be 14 years before treatment is needed" approach.

What does this all mean? Well, she had a two options for us to think about. The first option is Chemo. If you read my previous post, you understand the drawbacks to starting Chemo. Not only does it start the remission clock, it has pretty nasty side effects. The second option is a clinical trial starting in the next few months. This trial combines two drugs that have been used very effectively alone to put Follicular Lymphoma patients into remission. There are very little side effects and it can always be followed with Chemo if it isn't successful.

I know you're thinking, "What does a Clinical Trial mean? ... Does it mean it was used on lab rats first and showed promise so now let's try it on Dave? It's okay...that's what I was thinking too. The doctor gave us the research to read, as well as, assuring us that it has been used on humans in previous phases with over 75% success. We spent a lot of time sitting and talking with the doctor about all the pros and cons of these drugs. I'm not going to go into all the details as I'm sure I've already lost you... :) I know at this point I looked over at Dave and realized we both must look like deer in headlights.

The last thing she touched on was a bone marrow transplant down the road. She said we needed to meet with a transplant specialist to discuss finding a donor for Dave at some point. She said that it almost always comes to this and and we need to be prepared.

We left the appointment knowing four things:
#1. We have to get the results of the CT scan and bone marrow biopsy before anything can be
determined. We will meet with Dr. Blum again on July 25th.
#2. We are meeting with a third oncologist on July 23rd to get our third, different opinion. :)
#3. We found ourselves laughing hysterically when we got to the car and realized we'd received
a $40.00 parking ticket while we were in our 2 hour appointment. Funny how cancer puts things into perspective.
#4. We were going out for pizza and ice cream! Decisions could be made tomorrow!