It was the usual routine: a physical exam, some bloodwork, and a discussion about how I'm feeling. Everything looks fine on all counts.
A few highlights of the visit:
- Dr. R told me that he uses me as a "poster child" for other patients who are nervous about watching and waiting. He said that he doesn't use my name, of course. I told him he was welcome to use my name if he wanted to -- and that I'd be happy to talk to anyone about watching and waiting, or anything else related to Follicular NHL. He probably won't, but I was serious. At the very least, maybe he'll let them know that it takes a good 6 months to get used to the idea of watching and waiting.
- He said he was going to "pre-empt my question" and talk about treatment possibilities before I got a chance to ask first. I was mildly, jokingly insulted, and told him I hadn't planned on bringing up treatment options at all. He said he would probably go with Bendamustine (aka Treanda) if and when I needed treatment. In his opinion, the field seemed to be narrowing as far as preferred treatment choices, and Bendamustine seems to be the choice (it's as effective, if not more so, than CHOP, with with less toxicity). He talked about it like he thought I'd never heard of it, and since he was being "pre-emptive" and feeling smart, I asked a question about dosing schedules: Same as Rituxan, once a week? He said he wasn't sure; they'd used Bendamustine in the office with other types of NHL, but not yet with Follicular, but he thought it was the same schedule of once per week. (I behaved myself and let him feel smart, and didn't point out that it's a 21 day cycle, given on days 1 and 2. I also didn't point out the national clinical trial about to start that combines Bendamustine with Velcade. Furthermore, I didn't bring up the whole ASH presentation from last month that provided evidence that watching and waiting should be replaced with immediate treatment with Rituxan. My thoughts are obnoxious, but I can play nice when I have to....)
- He thinks things look good enough to hold off for 4 months until I see him again (though, of course, I'm welcome to see him sooner if there are problems). He actually thought the nodes in my lower abdomen seemed a little smaller than last time he felt me up. He also mentioned that it's coming up on a year since my last scan (early March), and he was considering ordering one in a couple of months, to keep them on a once per year schedule. But then he thought maybe we wouldn't bother, if there doesn't seem to be a need for one (that is, if there's nothing new to check out). I'm OK with that logic, though I do like to have some confirmation that everything is as good as I think it is. We'll see what May brings.
So everything seems good. I'll keep doing what I've been doing, I guess, since it seems to be working -- running, blogging, and being handsome.