Velcade

I've spent a couple of days mulling over what Dr. R said to me about other treatment possibilities. I've always had Treanda on my own personal list, even if it hasn't been on Dr. R's list that he had shared with me. (Though in his mind, obviously -- when he mentioned these other possibilities, he said he kept forgetting to mention them to me.)


But Velcade was new to me. The name is familiar, but it wasn't something I associated with Follicular NHL. I asked the support group if anyone had used it before, and a few had. Sounds pretty easy to take. It's basically an injection, twice a week with a week off. It works by inhibiting proteasomes, which are normal parts of all cells. As I understand it, they clean up spent and deformed proteins in the cell. Velcade keeps them from doing their cleaning up, which results in the cell dying. Seems like it would like one of those people on the show Hoarders, but without the intervention.


One very interesting thing I've found in my research is a warning that green tea might interfere with Velcade. Apparently, the antioxidant in green tea extract (which equals about 50 cups of green tea) binds to the Velcade, keeping it from binding to the cancer cells. Makes sense -- the job of an antioxidant is to bind to a free radical and render it harmless. Here, the green tea antioxidant is binding to something that might harm the cell and keep it from cleaning itself up. The researchers have only tested this in the lab, since testing it on actual patients would be "highly unethical." They though the green tea would cut down on Velcade's side effects, but instead found that it wiped out all of its positive effects. Fascinating.


Even more fascinating? The health care system in Britain agreed to a deal with the manufacturers of Valcade a couple of years ago, whereby they would get paid only if the Velcade worked. Apparently, about one-third of British patients did not respond at all to Velcade. Now there's some question about whether or not drinking large amounts of tea might have influenced those British patients' results.


Goes to show that nothing is as simple ("Antioxidants are good for you") as it seems.


More importantly, Velcade is now on the table for me. From what I've read, and from what I've heard from the support group, it's pretty well tolerated, easy to administer, has few short-term side effects, and its long-term side effects are more likely to be present only if it is taken for a long time (which Dr. R says will not be the case for me).


Add it to the list.

But I still have lots more to read and think about.