Tag Archives: chemo

Leper Treatment

hat

This issue caught my attention on social media last night and has practically gone viral since then. A high-end Nashville steakhouse called Mortons which apparently has a strict dress code for patrons delivered horrible and inhumane treatment to a cancer patient who chose to wear a knit cap on his hairless head to try to stay warm.

Right now, Fox17 WZTV is the only news outlet carrying the story but I expect that will change by newstime tonight.

According to numerous reviews on Yelp and posts on Facebook, a large party of about 16 people held a company Christmas party at Morton’s, The Steakhouse, in downtown Nashville, but there were no good tidings. After spending more than $2,000 at the Church Street location, one of the men dining with the group put on a wool beanie. Witnesses say he needs the added warmth because he is a cancer patient undergoing chemotherapy. The diners say their friend was asked to remove his hat, and explained the situation to the manager, who allegedly said that the gentleman should bring a doctor’s note or call ahead so that he could be seated in a private dining area. Witnesses say the cancer patient along with his wife and kids became very upset over how the situation was handled and they stormed out to leave. The police even arrived.

Since when did a restaurant’s dress code ever trump basic human dignity? I can’t envision a more terrible management and customer service experience. I am embarassed for our city and outraged, no perhaps indignant as a fellow cancer patient. Morton’s is permanently off my menu.

Hopeful CLL commentary from Dr Bruce Cheson

Here’s a snippet from his post about the upcoming ASH (American Society of Hematology) conference in New Orleans, LA in December. My own doc, Dr Ian Flinn will be presenting on trial data with ipi-145. I can’t wait. There is a video on page one but the audio did not play well for me. Here’s page three from the article

Bumper Crop of New Agents

The rest of the studies focus on the new agents. We have several ibrutinib trials, including a single-agent study in patients with or without 17p deletion. There will be the final analysis of bendamustine and rituximab plus ibrutinib.[13] Do you need the chemotherapy? Do you need the bendamustine? There will be another abstract[14] with rituximab and ibrutinib alone.

This isn’t the only exciting drug. There are phosphoinositide (PI) 3-kinase inhibitors, which appear to be very good and are very impressive, perhaps as good as ibrutinib when you combine them with a drug like rituximab. In fact, a recent study of rituximab-idelalisib vs rituximab-placebo was closed early because of a survival advantage.

We are also going to be seeing a list of new PI 3-kinase inhibitors for the treatment of CLL: a new delta inhibitor, a new gamma inhibitor, and others. We’ll have to see which of these provides an advantage over the others, if at all. But in any event, we have great new drugs that will be changing the landscape of non-Hodgkin lymphomas, Hodgkin lymphoma, and chronic lymphocytic leukemia.

This is Bruce Cheson, signing off for Medscape Hematology. I will be back with you after the ASH meeting in New Orleans. See you there. Goodbye.

17p Deletion in CLL

karyotypeRe-Blogging something I found yesterday which helps explain small arm 17p deletion; the chromosomal mutation I have which makes my CLL more sinister. Dr Sharman helps explain it well and explains why traditional chemotherapy regimens like FCR (Fludarabine,Cyclophosphamide & Rituxan) for CLL generally don’t work well for patients w/ 17p deletion.. Thanksfully, Ibrutinib is well on its way to approval by the FDA and the trial drug I am taking (ipi-145) also seems to be working for me. Here’s a snippet of his post. You can read his full post via Dr. Sharman’s CLL & Lymphoma Blog

When we say 17p deletion CLL, what we mean is that the short (petit) arm of chromosome 17 is missing.  You have 23 pairs of chromosomes (46 total) and as you get higher in the numbering, the chromosomes get smaller and smaller.  It is probably an excessive simplification to say that the biology of 17p is all about one particular protein called p53 – but for the time being that is most of the story.

P53 is affectionately called “the guardian of the genome.”  Every time I read about p53 I discover some new function of the protein that I didn’t know about before.  It has a tremendous number of different functions.  One of the most important though is that it will bind to DNA in a bunch of places and turn on / off the genes at those locations.  In this role it is known as a “transcription factor.”  Many of the proteins that are regulated by p53 have to do with cell survival or cell death.  When P53 decides it is time for a cell to die – very few things can stop that.  The most important signal that turns on p53 is DNA damage (hence – guardian of the genome).

The future of cancer treatment?

imageThe days of toxic chemotherapies may be slowly coming to an end as advanced research and clinical trials yield smarter drugs which interrupt specific metabolic and signalling pathways that ultimately allow the cancer/tumor cells to live and grow. In most cancers, the process of apoptosis or normal programmed cell death is broken. If this works according to plan, this drug compound, a PI3K inhibitor will do that for me and allow my bone marrow to get back to its normal job of producing new blood cells to replace those which have done their job and died – the way they were always supposed to. Please stay tuned.

Chapter One

image20a

Hi! I’m Don. I was diagnosed with Chronic Lymphocytic Leukemia (aka CLL) in September of 2011. Since then, we’ve done lots of bloodwork and a bone marrow biopsy in something known in clinical circles as “watch and worry”. We’ve steadily and patiently watched my white blood cell counts rise and my red blood cell & platelet counts fall.My lymph nodes have gotten pretty big and in general, I am fatigued and don’t feel really good most days.

Fast forward to August, 2013.

This week, my platelet count had fallen to 74000 so my oncologist Dr Flinn and I both agreed that it was time to begin treatment. I have a genetic mutation called short arm chromosone 17p deletion. FCR (Fludarabine + Cyclophosphamide + Rituxan) is the standard chemotherapy regimen for CLL these days but it’s not known to be all that effective in terms of achieving durable remissions for those of us in the 17p club. Without a bone marrow/stem cell transplant, this is not generally considered a curable cancer and managing it over the long term is what we’ll have to do. We looked at some new therapy options and I believe we found a good fit. It’s all unfolding really fast and in the last few days, I’ve enrolled in a clinical trial for a new B cell receptor pathway signalling inhibitor currently called ipi-145. I will begin treatment next week. We’re gonna drop-kick this cancer with zero mercy! This is where the story begins.

drop-kick