Cycle Three – Jay’s Third Mantle Cell Lymphoma Treatment—Cruising at Altitude
Updated: Oct 3
Every case of Mantle Cell Lymphoma is different. I'm sharing our journey, not offering medical advice. Treatment decisions should always be made with your oncology team.
Great Visit with Oncologist Before Jay’s Third Mantle Cell Lymphoma Treatment
During Jay’s physical exam before his third Mantle Cell Lymphoma treatment, his oncologist indicated that the treatments appear to be working. Jay’s lymph nodes seemed to have returned to normal size, and he had gained four pounds. While it isn’t difficult for the majority of Americans to gain a few pounds, the presence of MCL in Jay's GI tract had made it difficult for him to gain weight.
The oncologist ordered a CT scan and an MRD test before Cycle Four. MRD, measurable residual disease, testing can detect microscopic amounts of cancer cells or tumor DNA that may remain in the body after treatment, even when standard scans show no evidence of disease.
The advances medicine has made in treating and detecting cancer is nothing short of a miracle!
Probable Maintenance Treatment After Cycle Six
Assuming the CT scan and MRD test indicate no evidence of disease, which his doctor expects, the oncologist proposed a maintenance treatment plan for one year.
The plan would decrease Jay’s rituximab, a monoclonal antibody, infusions to every eight weeks and replace acalabrutinib with pirtobrutinib, a third-generation BTK inhibitor taken as a pill.
Fun fact. Pirtobrutinib’s brand name is Jaypirca.
Jaypirca to treat Jay.
It’s definitely a sign that this is the BTK inhibitor for Jay. 😊
However, based on my online search, Jay's Medicare drug plan may deny coverage for Jaypirca if it is prescribed for maintenance.
I’m going to leave this decision in God’s hands.
Gratitude and a Sense of Humor
Infusions feel like visiting your housebound great-aunt, who is leaving her estate to her cat but expects you to visit every twenty-eight days.
There are other places—almost anywhere else—you’d rather be, but she needs some company, and you are noble, so you go.
The nurses at the infusion center are like your cool cousin who comes to Great-Aunt’s house bearing snacks and jokes to keep your spirits up and help you pass the time.
While I thank God for the highly effective Mantle Cell Lymphoma treatments—and that he has experienced only mild adverse reactions—if I had my druthers, the disease would never have made an appearance in Jay's body. But it has, so we pack our bags and make the monthly trek to Great Auntie's, determined to make the best of it and not allow the disease to steal our joy—or our quirky sense of humor.
Jay's Third Mantle Cell Lymphoma Treatment
Thank goodness, the rituximab infusion takes less time each successive cycle—only an hour and forty-five minutes this time. Bendamustine is the sprinter in the group, finishing in about ten minutes each of the two treatment days.
Compliments of the pre-infusion steroid, Jay wakes around 3:30 every morning following the infusions. The fact that he feels good is also, thanks to the steroid.
Apparently, steroids have decided that sleep is optional.
Day 4 After Infusion
Jay’s stomach felt a little off. The same thing happened around this time after the first two cycles and lasted three to four days as well.
We suspect it may be related to the pre-treatment medications—steroids, Zofran, and Benadryl—wearing off while the bendamustine and rituximab are still working in his system.
Whatever the reason, it has followed a fairly predictable pattern after each cycle so far.
PSA Level at Record Low
Jay has had an elevated PSA level for years, so he was pleasantly surprised when his latest result came in at 3.7—the lowest it has been in the past seven years.
Could all of these treatments be having a positive effect on his prostate? We don’t know, but it’s certainly a welcome number.
Jay has also noticed that his hair, fingernails, and toenails are growing at a superpower speed.
Bendamustine does not target the hair-root cells as aggressively as some other chemotherapies, but still, it doesn’t seem like hair and nails should grow faster during treatment.
If only it promoted new growth where he’d already lost hair.
Now that would be a treatment side effect worth celebrating.
Cruising at Altitude
“The seatbelt sign has been turned off. You may move around the cabin.”
We are eagerly anticipating the CT and MRD tests. However, just like on an airplane, we’ll keep our seatbelts loosely fastened when we’re in our seats. Afterall, we never know when we might encounter turbulence.
For now, though, it feels like we’ve reached a little stretch of calmer skies. Jay is tolerating his Mantle Cell Lymphoma treatment well, his doctor is seeing signs that the treatment is working, and we have plenty of reasons to be thankful.
I leave you with this scripture:
“Be strong and courageous. Do not be afraid or terrified because of them, for the Lord your God goes with you; he will never leave you nor forsake you.” Deuteronomy 31:6 NIV
Be fearless! God is forever by your side.
Blessings,
Angela
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Angela L. Gold is an encourager who shares the love of Christ in her writing. She is the author of The Lion Within and Kill Shot.
