With my cancer management plan in place, life settled into a routine of quarterly blood tests and physical exams, punctuated by an annual PET scan to track the subtle nuances of my Mantel Cell Lymphoma (MCL).
In the realm of watch and wait for MCL, the general trajectory tends to usher most into actual treatment within a year. Diagnosed on April 8, 2019, the one-year mark, on 12/23/2020, marked my second PET scan. It revealed growth in my MCL, albeit with a reassuring Deauville score of 4—still holding onto its indolent nature. My blood tests reflected normal ranges, though my platelet counts showed a gradual decline to 174 K/ul. In the backdrop of the tumultuous year that was 2020, I navigated the pandemic unscathed, fortified by Covid-19 precautions due to my immunocompromised status.
2020, despite the global challenges, turned out to be a stellar year for my running pursuits. Personal bests in the 1 mile, 5k, and 10k runs were achievements that underscored my resilience.
Fast forward to 12/20/2021, and my PET scan mirrored the gradual expansion of my MCL. Deauville scoring held steady at 4. Notably, my platelet counts dipped to 136 K/ul, but this wasn’t a cause for immediate concern. Running remained a constant, a testament to my physical well-being.
In 2022, my running mileage saw a decline, not due to health issues, but a shift in personal drive. My annual PET scan was slated for 1/9/2023, adhering to the insurance-mandated one-year interval.
Having trodden the watch and wait path for over three years, well beyond the typical timeframe, I reflected on the journey since first noticing the lump in 2016. Remarkably, five years had passed without any overt symptoms, signaling the need for treatment.
The turning point arrived with the 1/9/2023 PET scan. The once-indolent MCL in my left pelvic area now resembled a turbulent weather pattern on radar. Uptake soared from 6.6 to 33.8, and my platelet count dipped to 120 K/ul, falling below the normal range at UW Health Carbone. Though classic symptoms were absent, a general sense of unwellness crept in, exacerbated by the mental toll of anticipating the need for treatment. With an active tumor area, no longer indolent, the time had come for a bone marrow biopsy, a biopsy of the highly active tumor site, and the need to develop a treatment plan.