Diagnosis

THE PATIENT

Friends,

Most of you may know I was on a weekend ski trip back in January when I lost my balance and fell on the slopes, resulting in a couple of ribs sustaining mild fractures . . . then in early March, I was in an auto accident down in South Carolina where somebody T-boned me at an intersection. I took precautionary x-rays, that showed no chest or bodily injury and stayed down there until returning home April 3.

When I got back, I did go see my regular doc at Baptist, who ordered some chest and skull x-rays. They revealed a number of “cytic lesions,” mostly on my upper torso. The early indication was a cancer called multiple myeloma. I was then referred to CBC Group, Consultants in Blood Disorders and Cancer, over on Kresge Way. Dr. Winjian Zhong was the physician I saw. He ordered complete blood work and performed a bone marrow needle biopsy (such fun, huh?). The bone marrow biopsy confirmed I have multiple myeloma, which is basically saying I have metastatic bone cancer . . . but when the blood work was performed, it showed plasma cells in the circulating blood, leading to a stunning diagnosis of plasma cell leukemia, a rare variant of the myeloma. I had been feeling just fine, so needless to say, I was floored. 

A longtime tennis buddy of mine beat leukemia 23 years ago . . . he and I have talked a lot in the last week, and his support, friendship and knowledge have proven invaluable. While our diseases are different, the results I seek are identical to his: a CURE as well as the confidence that I can resume a normal and healthy lifestyle.

In addition to 2-3 rounds of chemo, I am going to have to undergo a “stem cell transplant”. I have been referred to Dr. William Tse, the new head of the bone marrow and transplant program at U of L’s Brown Cancer Center. Dr. Tse is a very accomplished physician and provided the second opinion I needed so that we could move forward with treatment. In the next 4 weeks, I must decide on exactly what transplant and cancer center will perform this critical procedure. Dr Tse trained in Seattle, and he’s recruited several docs from the Fred Hutchinson Cancer Center in Seattle who will be joining him early July. Seattle Cancer center is a top notch facility, reputed to be one of the best in the world. In fact, Seattle is where my tennis buddy had his transplant. Dr. Tse points out that having a “support group of friends and family” is a KEY element in a successful procedure and positive results. So at this point, I am leaning on doing this transplant at U of L vs traveling to another facility such as MD Anderson, Vanderbilt, Mayo Clinic, or Sloane Kettering. More on that later.

This coming Monday, May 4th, I will begin chemo treatments at Baptist Hospital. I will be in the hospital for 7-10 days, enjoying a slow drip infusion of chemo. Then, after feeling somewhat better, I will head home to get some rest and continue some oral medication chemo until end of May. Then, the process is repeated starting around June 1, until all the cancer cells are eventually killed off. Once all those bad cells are dead, that’s when the transplant would take place.

So, as much as I would love to be chasing down tennis balls, or driving a ball down a fairway, it looks like my competition this summer will be in my own bloodstream. This is my second battle with cancer, having beaten colon cancer back in September 2000. This leukemia may have a head start, but it has no idea just how hard I will fight back. Clearly, it chose the wrong hombre to mess with.

Of course, feel free to stop in over at Baptist, but above all, I would appreciate your thoughts and prayers as well, as I get ready for a journey that I plan to WIN.

I'll post updates here during the course of treatment, and I would love to read your comments below.

Gary

GARY'S DOCTORS:

Wangjian Zhong, MD, PhD

Dr. Wangjian Zhong joined CBC in July 2008.

Dr. Zhong was born in Shanghai, China.

He obtained his medical degree from the Shanghai Medical University in 1990.  He was trained in General Surgery in Shanghai for more than three years before he came to the United States for his graduate study.  Dr. Zhong received his Ph.D. degree in Immunology from The Ohio State University in 1998 and continued his immunology research at the same institution for several more years.  In 2005, Dr. Zhong finished residency in Internal Medicine at Indiana University School of Medicine.  He became board certified in Internal Medicine in the same year.

Dr. Zhong recently finished fellowship training in Hematology and Medical Oncology at the Brown Cancer Center, University of Louisville School of Medicine in 2008.   He conducted translational research in the laboratory there in an effort to advance the treatment of human cancers.   His main areas of interests are lung cancer and colorectal cancer.

Dr. Zhong is a member of the American Medical Association, the American Society of Clinical Oncology, and the American Society of Hematology.

William Tse, M.D.

Dr. William Tse is Professor of Medicine and attending physician at James Graham Brown Cancer Center, University of Louisville School of Medicine.  Dr. Tse received his medical degree from Sun Yat-Sen University School of Medicine, Guangzhou, P. R. China. He completed his internal medicine training at Long Island Jewish Medical Center/Albert Einstein College of Medicine and Medical Oncology/Bone Marrow Transplantation Fellowship at The Fred Hutchinson Cancer Research Center/University of Washington School of

Medicine.  Along with his clinical training, he received his laboratory research training at the Ontario Cancer Institute/Princess Margaret Hospital and The Hospital for Sick Children, University of Toronto, Toronto, Canada.

Dr. Tse is focused on clinical and translational cancer research for hematopoietic malignancies including pre-clinical models for developmental therapeutics, cancer biology, and cancer cell signaling network profiles. Tse lab translational research is focused on the paralleled signaling pathway activation in cancer and leukemic stem cells. Dr. Tse identified a novel co-factor, AF1q, interacts with T-cell-factor (TCF) associated transcriptional machinery that activates the stemness related Wnt signaling pathway and turns it into autonomously deregulated. At the meantime, the AF1q co-factor also simultaneously activates the Notch and PDGF/Stat3 signaling pathways that are also associated with cancer and leukemic stem cells behaviors. Tse’s work demonstrates an innovative multi-targeted therapeutic approach for a subgroup of leukemia and solid cancer patients that have the AF1q-centered aberrant signaling pathways.

He received the National Cancer Institute of Canada’s Terry Fox Physician Scientist Fellowship Award, the Association of Specialty Professors (ASP) T. Franklin Williams Scholar Award, and the ASCO Career Development Award.  Other honors that he has received include the Dr. Irwin Katzka Memorial Award for Humanitarianism and Resident Teacher of the Year from Long Island Jewish Medical Center, Albert Einstein College of Medicine at Long Island Campus.  He also actively serves on multiple journals’ editorial boards, including PLoS One, Journal of Hematology and Oncology, American Journal of Stem Cell, American Journal of Blood Research, and Experimental Hematology and Oncology.

(Doctors' bios were taken from their websites.)