Slight Progression

My MRI today produced fine crisp images that showed my nodes have grown slowly since the last CT in September and now the largest in the mesentery is 6.3 cm in its widest measurement.

What makes it more confusing is that the report from September was revised upward suggesting both that the response to the rituximab after the June CT was very much less than I had thought it was last fall, but on the other hand, the growth since has been quite slow.

But the growth may not have been linear, but rather a U curve with a early drop, and a recent growth spurt in node size.

Remember please that I had more rituximab since the last CT that likely shrunk the nodes (this was never documented and so is just my speculation) that are now rebounding. I will never know for sure, but it makes sense.

More later. Too tired to write tonight.

My nodes are bigger

I had almost noticed a mildly irritating fullness in my armpits, and now I know the reason why.

My axillary lymph nodes have grown.

I don't need no stinkin' MRI to make that diagnosis.

I can tell when I shower. It is isn't subtle. With the body soaped up, the skin disappears to the palpating fingers and the nodes pop out large and unwelcome.

The MR can't come soon enough, because it is all that is holding me back from the rituximab which now seems more like the critical piece of a remitting therapy than a gentle and unproven maintenance therapy.

Let me explain.

My CLL has always acted more as a lymphoma than a leukemia, always been most troublesome in my nodes, the true proliferative centers in CLL: the last place for my cancer cells to die, and the first home to be reborn. The nodes are where the action is, where the battles are won or lost.

Fortunately the neck nodes, while also bigger and more numerous, are still pretty tiny, and my lab remains good. And I feel well. The MR will tell us so much more, but not until mid June.

It is clearly no longer possible to argue that the purpose of the Rituxan is to maintain the quietude of my cancer, to keep it sleeping. It has awoken first in my nodes, again. Just like it did post transplant.

But it is more true that the cancer hardly demands treatment now. Not even close. If fact, none of the consensus reasons for treatment are anywhere to be seen. My red cells and platelets are holding up, my lymphs are going anywhere, let alone not doubling, and I have no B symptoms, my fatigue not withstanding. And my bone marrow biopsy report revealed a very low tumor burden just a few months ago.

The "plan" discussed in the last post now seems more of a hammering back of the CLL, like bashing down those pesky gophers at the arcade, only to have another pop up somewhere else.

I am anticipating another 6 month run with this bashing of pesky node before I need to get out the monoclonal antibody hammer again.

On a much more important note, I am back from a wonderful visit to my daughter who looks so radiant and full of joy and life with her third trimester belly.

My wife and I and our eldest son and a few of our dearest friends drove up to Emeryville to join her bay area friends for a wonderful baby shower.

I will post some picture soon. It was so fun.