Mar 02, 2013 - 1:06 pm
My name is Eric Edwards, 55 years old, male, located near Albany, NY, and first and foremost I'd like to thank all of you for your timely and supportive posts. I'm also bipolar, suffer from major depressive disorder, controlled hypertension, high cholesterol, borderline but not diabetic, GERD, and am a recovering alcoholic (4 years next month); I fully understand the necessity of support and hope to contribute to as well as benefit from this discussion board.
About mid-December of last year I noticed a mass on the left side of my neck which was increasing in size. When I first saw my primary care physician about it on January 3, it was approximately the size of a deviled egg. I'd been thinking that it was just a swollen gland like I'd had as a kid with a sore throat, so although my doc mentioned the possibility of a CT scan and a biopsy, we decided to spare the healthcare system and start with an anitbiotic. By the following Monday there was no improvement, so I had a CT scan on Friday the 11th. I was given the results by another doctor in the practice I visit on Monday, and very quickly (I thought) I was having a consult with a surgeon for a biopsy on Thursday. The following Monday I was admitted to Albany Medical Center, had the biopsy, met who was to become my oncologist/hemotologist (with New York Oncology Hemotology, NYOH), was given a MUGI scan and was released on Wednesday, Jan. 16, being informed that the biopsy results would take a week to ten days. I had my first consult at NYOH the next Monday; the biopsy results had been completed and I was diagnosed with a Stage III highly advanced, highly aggressive DLBCL. The initial treatment plan was for eight courses of chemo with a 4-6 day hospitalization with each. That week brought blood work, a PET scan, a bone marrow biopsy, and another hospitalization to place a port and receive my first chemo treatment. The following week's appointments included a Neulasta injection, blood work, and another visit with Dr. Brake, my oncologist. With the PET scan results, I was told that my treatment would be only six courses of chemo, done on an outpatient basis, and that the lymphoma was not as aggressive as originally thought. To this point, my thoughts and emotions had been a rollercoaster (to say nothing of my poor wife Lori), and I had experienced and appreciated a sense of urgency not previously demonstrated by my experience with the medical profession. Dr. Brake told me that I had tested negative for the CD20 cell marker, disallowing Rituximab (the "R" of "R-CHOP"); the CD20 marker differentiates between B and T cells, generally allowing Rituximab to target only B cells. Dr. Brake didn't seem overly concerned.
On February 8, my wife Lori and I traveled to Boston for a consult/second opinion with Dr. Arnold Freedman at the Dana-Farber Cancer Institute. I was impressed with the facility but unimpressed that the biopsy pathology had not arrived ahead of time, and Dr. Freedman wasn't able to discuss my specific case without benefit of a second analysis of the pathology. He was more concerned with the absence of the CD20 marker, but didn't then know if the test had produced a false negative. He mentioned the possibility that my case could involve plasmablastic lymphoma, which he said was extremely rare. He has since reported that all of the results of pathology done by NYOH were accurate, and that the result of the CD20 analysis is a true negative. I'll find out from Dr. Brake this coming Wednesday whether or not what I have is plasmablastic lymohoma.
I'm wondering if anyone is familiar with this strain of DLBCL. What I've found online is that it is, in fact, extremely rare as presented in my case. Generally, it is most common in those who are HIV positive (I had myself tested this week and am HIV negative). More common, too, is that it presents with oral cavity involvement which, so far, it hasn't in my specific case (although Dr. Brake has been visually checking). Not even a mouth sore of any type. From what few statistics I've found, the prognosis is poor, but even worse for those who are HIV negative. Although I've been surprisingly good with all of this, I could use some encouraging news.
Thanks to all in advance, and I look forward to becoming an active member of this discussion board.