Now armed with an official staging, it was time to formulate a plan. My Oncologist presented a decision matrix, considering factors such as my age (58), overall good health, and Mantel Cell staging at 3, coupled with a Ki-67 exceeding 20%. The suggestion on the table: an autologous stem cell transplant. Quite the WTF moment, considering the intensity of such a procedure and I felt perfectly fine!
Having delved into numerous clinical research papers from the Carbone Cancer Center at UW Health in Madison, I sought a second opinion from Carbone, given their specialization in MCL cancer. My doctor agreed, and the referral was promptly made.
Enter Dr. Saurabh Rajguru, whom I met on 5/7/2019, not even a month after the initial cancer revelation. Dr. Rajguru, having perused my PET scan and bone marrow biopsy, ordered additional blood tests for comparison.
The discussion unfolded, revealing that although I indeed had Stage 3 Mantel Cell lymphoma, the quantity of tumors was deemed “unremarkable.” Dr. Rajguru laid out the options: a stem transplant was on the table, but considering the indolent nature of my MCL (slow-growing), a “watch and wait” strategy emerged. Essentially, monitor my physical state, along with blood tests, and initiate treatment when deemed necessary.
This option resonated with me, given my current well-being. The question loomed: “could waiting impact future treatment success or my overall quality of life negatively?” Research reassured that the timing of treatment initiation wouldn’t significantly differ.
The “watch and wait” approach typically applies to 15%-20% of MCL patients, with treatment likely starting within a year. Opting for this strategy, I saw no urgency to dive into intense chemo, endure weeks of hospital confinement, and potentially miss out on evolving treatment options while in the watching and waiting mode.