Monday, May 6, 2013

My Transplant: The Odds - Part One

The moment you are diagnosed with cancer, your world shrinks to the size of a pea. Suddenly the only language you speak is the language of statistics and percentages.

I constantly harass my doctors to give me the odds: the odds of the chemotherapy working, the odds that I'll go into remission, the odds that I'd have to have a transplant, the odds that I would relapse, the odds that the transplant will keep...

When I was first diagnosed in late 2011, due to the basic stats of my age, sex, and health, I had a 60% chance of survival. In hindsight, 60% is better than 50%, however a 60% survival rate also meant I had a 40% chance that cancer would do me in. And anything less that a 100% chance of survival is devastating no matter what your odds.

I always imagined it this way: For every three ALL patients, one will die.

I knew the odds. After I met with my hematologist, I had a big decision to make: which chemotherapy regiment did I want to try. Basically I had two options, each with its own set of odds:

Choosing the Adult Protocol: My odds were the same - 60% survival rate.

Choosing the Pediatric Protocol: IN CHILDREN, the odds were 80% I'd go into remission. NO concrete data (yet - see below) for adult patients who've undergone this protocol.

There is currently a clinical trial found here that is gathering data for the effectiveness of using the Pediatric Protocol on adult patients. While I was diagnosed this clinical trial still had five more years before any concrete data could be gathered.

It all comes down to what set of data the odds are pulled from.

The Pediatric Protocol odds are based on data gathered from cases of children under the age of 18-20. The Adult Protocol is based on data gathered from adults ages 20 and up to 85

I was 25. Technically, I fell into the adult category. The alluring 80% survival rate was based on cases of children with cancer, not adults with cancer. According to my doctors, there is a huge difference between how children and adults accept chemotherapy treatment.

So my choice was this: choose a proven 60% survival rate from a protocol designed for my specific age group, or choose a protocol that had very little data, positive or negative, to back it up.

Upon my hematologist's advice, I chose the Pediatric Protocol. After Induction (described here, or check out all these and these), I was in remission, and my doctors put my odds at 90% survival.

But, despite these odds, there was still that spot of red, that chance of relapse. So, I needed a Plan B in case the chemotherapy failed to work or if I relapsed after remission.

Plan B was a bone marrow transplant, and for a while I didn't think I'd ever need that option.

Stay turned later this week for The Odds - Part Two.

1 comment:

  1. Hi there.. I really love your drawings/cartoons/comics. Its amazing. I just wanted to ask whether I could use some of your drawings?. I'm actually during my phd project on graft versus host disease. Trying to improve its effects with a 'drug' but in mice not in humans. I hope to get some successful results to help leukemia patients.