I often burden you, dear readers, with my personal odd-servations and ramblings, so let me divert from that somewhat narcissistic narrative and offer some real information for the value of my Cancer Cadre. In the world of cancer treatment, they often use the term "lines“ (as in Lines of Therapy). "Lines of therapy” is the term used to describe the order in which different therapies are given to people as their disease progresses. In my case, over the past 7+ years, I have had 4 evolving lines of therapy. FYI: Much like the military, chemotherapy regimens (cocktails) are expressed in acronyms.
- CyBORD - Cyclophosphamide, Bortezomib and Dexamethasone
- Elo/Rev/Dex - Elotuzumab, Lenalidomide, and Dexamethasone
- Dara/CFZ/Dex - Daratumumab, Carfilzomib and Dexamethasone
- Dara/Pom/Dex - Daratumumab, Pomalyst and Dexamethasone
I bring this all up for two primary reasons.
First:
To share some background on Lines of Therapy. On the surface, it may seem like the doctors don't know what they are doing so they keep changing the regimen until they get it right. Cancer treatment varies for each patient, and in my case, they started by carefully examining my blood work (each month) and my DNA, to determine exactly which strain of Multiple Myeloma (MM) I had, and then attacked it with a chemo weapon. If they didn't get the degree of results that were expected, there were other combinations to explore - all within the context of my disease and related medical challenges (I presented with badly compromised kidneys from my undiagnosed MM, so each successive cocktail is a balance of optimum efficacy and nephrological prudence).
Second:
I'm establishing this background, because I recently had the dosing level of my Pomalyst (Dara/Pom/Dex) changed from 1mg per day (tablet) up to 3mg. The Pomalyst is a very small daily amount of chemotherapy intended to maintain the suppression of growth of my myeloma cells. Dosing began at 4mg, and then was slowly dialed down to eventually 1mg (as little ongoing chemo as possible is the goal). But when the Onc team began noticing a small but consistent upward trend of myeloma back in my system, they returned to 3mg. We'll monitor this monthly at each of my infusion sessions and determine if the dosing: can be lowered, needs to be raised, or is held as is. This is the reality of the as-of-yet incurable (though not terminal) form of cancer that I have.
A little primer about my lines of therapy, in hopes it can help demystify the conversation should you or your loved one be diagnosed and then treated for any form of the disease.
