Week 83 chemo complete: Cancer levels increased

I’ve been misinterpreting my monthly blood test results.

I went in for my monthly big blood test for September to determine what my Hematology profile is (how my body responds overall to my chemo treatment) and learn what my Serum Proteins (Electrophoresis & Immunoglobulins) are, which are my cancer levels.

I’ve also had my quarterly Hematologist appointment, during which we extensively discussed my September blood test results. I learned that my cancer levels had actually increased, rather than remained stable as I had understood.

Multiple Myeloma is a cancer of the bone marrow, in which myeloma is the abnormal protein or cancer in my blood. The M Protein test only measures this bad protein. Therefore, it is 100% accurate in telling me what my cancer levels are.

The Beta 2 test and the igG tests measure good protein + abnormal protein in my blood, so although they have monitoring value, the M Protein test result is more significant.

M Protein (g/L)
Sept = 2.8
Aug = value missing
July = value missing
June = 1.9
May = 1.7
Apr = 2.5
Mar = 3

If I want to determine my temperature, to determine if I have a fever, I will use a thermometer (M Protein test). This will provide an accurate result compared with feeling if my forehead is warm (Beta 2 or igG test).

For July and August, I didn’t have a M Protein value. My Cancer Specialist didn’t know exactly why, but had a few ideas. Apparently it is not always possible to do this particular test on bloodwork, however in case it was an oversight, my file has been noted to ensure it is done each month.

There are three interpretations of my test results showing elevated cancer levels now (M Protein = 2.8 g/L) compared with June (M Protein = 1.9 g/L).

Each Monday I take a steroid called dexamethasone (dex) with my chemo. Generally in multiple myeloma studies, dex + chemo is more effective (i.e. lowering/stability of cancer levels), than just chemo alone. However, dex has really brutal side effects, so ideally my Specialist would prefer that I just be on chemo.

When I began chemo treatment on Feb 2015, I was taking 40mg of dex, which have gradually reduced over time, as my cancer levels have dropped. After my June test, my dose was reduced to 4mg. However, as my cancer levels have now increased, it is possible that the lower dex dosage reduces the effectiveness of the chemo.

A second possibility is that the chemo is no longer working, meaning a different chemo treatment would have to be explored.

A third interpretation is that the chemo is still working great at keeping my cancer levels low and stable. When I get my October test results they will show a similar result as September or they will drop.

If my cancer levels continue to increase, then the first step is to double or triple my dex dosage (currently 4mg), before considering another chemo. However, I remain hopeful that my October and November blood test results will look good.

Thanks everyone for your encouragement and ongoing support.

BOLD = outside normal levels

My Hematology profile (how my body responds overall to being on treatment) looks good.

Friday afternoon I travelled to the Capilano Dam in North Vancouver. As it began to lightly rain, I walked through a beautiful canopy in the forest.

Nature is magical!

To recap: On Sunday, September 11th, I completed Cycle 21 Week 3. I have Multiple Myeloma and anemia, a rare blood cancer. It is incurable, but treatable. From February to November 2013, I received Velcade chemo through weekly in-hospital injections as an outpatient. Since February 9th 2015, I have been on Pomalyst and dexamethasone chemo treatment (Pom/dex).

Weekly chemo-inspired self-portraits can be viewed in my flickr album.

May 2014: Coal Harbour Boathouse

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