Two Things

The St. Raphael's hospital's Father McGivney Cancer Center recently opened up about a half mile from my house. It's a new addition to the buildling where Dr. R used to have an office. (His practice is still there, but he moved to an office about 20 minutes away.)

It looks like a very cool facility, with some cutting-edge technology, and will save a lot of people from traveling to downtown New haven (which isn't that big a deal, but when you're going in for a treatment, it's one less stressful thing to worry about).

The Cancer Center had an open house on Sunday. Isabel and I joked about what exactly a cancer center Open House would be like. Naturally, I went where I shouldn't and suggested there might be entertainment (Chemo the Clown, maybe?). Our local paper had a story about the open house this week. No photos of clowns, but there was a picture of a CT/PET scan machine with balloons on it. Unfortunately, I can't find it online.

Come on, kids -- who says radiation-based diagnostic imaging systems can't be fun, huh?

*********************

Catherine is playing softball this year, and I was roped into coaching. There's another guy who's head coach. At first, he just "needed a little help with practices." Then I somehow became official assistant coach. Soon after that, he told me, "You know, sometimes I need to go out of town for a few days for work..." (That's only happened once, and the game got rained out, so I didn't have to be interim head coach for the night.)

It's actually kind of fun. I was assistant coach at various times for the boys' baseball teams, so I don't mind doing it, and most of the girls on the team are a trip and keep me smiling. At Catherine's age, it's a "coach pitch" league, so while the head coach pitches to the girls, I keep score, coach first base, and help out where I can.

But Tuesday night, the coach asked me to pitch for the first time, so he could work with the girls as they were up at bat. I had pitched some to the girls during practices, but this was my first time during a game. Catherine happened to be the first batter that I faced.

I hit her with a pitch.

Now, those of you who know Catherine know that, since she's been about six months old, Catherine has had what her pediatrician called a "disarming stare." After I hit her with the pitch, I got that stare. It's kind of through half-closed eyes, with a look that says both "You're lucky I have so much self control" and "You're buying me ice cream after the game."

She was fine. I didn't even let her take first base.

There's no crying in softball. No balloons or clowns, either.

Catherine and Dad, in the happy days before I hit her with a pitch....

Speak of the Devil....

...or an angel.

Here I am writing about lymphoma vaccines, and how they've seemed to hold so much promise, but just aren't working, and BOOM, there's a news story about lymphoma vaccines. It's a good one, too.

The American Society of Clininal Oncology (ASCO) is in the middle of their annual conference right now (see all the summaries/abstracts for the lymphoma-related research here), and one of the big success stories has been the presentation on the vaccine for follicular NHL. It was part of a mainstream, Associated Press news story on cancer vaccines.

Apparently, the fNHL vaccine is working. The ASCO presentation looked at 117 fNHL patients who had been in remission after chemo. The research showed that the group that didn't take the vaccine had an average of 30 months before the NHL returned. Those who had the vaccine took 44 months.

Now, an extra 14 months might not seem like a big deal, but given the results of previous vaccine studies, this is major, major good news. As the news story points out, "That's huge in this field, where progress is glacial and success with a new treatment is often measured in weeks or even days."

So, this vaccine isn't The Answer -- not yet. Again, from the news story: "It's way too soon to declare victory. No one knows how long the benefits will last, whether people will need "boosters" to keep their disease in check, or whether vaccines will ever be a cure. Many vaccines must be custom-made for each patient. How practical will that be, and what will it cost?"

But it seems like a major step on the way to making this particular treatment work. Think about what I wrote about last time, with other researchers seeming to have found out why vaccines aren't working. Imagine, in a few years, taking something that already works well, and improving it even more.

Pretty rare that follicular NHL makes it into a news story. I'm glad it was good news.

Research, as promised

As promised, some new research.


The Instutute of Physics released news last week about what they call a "breakthrough in radiotherapy." Traditional radiation is pretty good at focusing on tumors, but some healthy tissue does get destroyed in the process, causing some nasty side effects. The "breakthrough" involves combining radiation therapy with an MRI. The MRI allows more focused aiming of the radiation, but it also provides the radiation oncologist with a "real time" view of the tumor, so the beam can be adjusted in response to the tumor shrinking or moving. Radiation isn't necessarily used in later stage follicular NHL like mine, but it sometimes is used on a stubborn node that won't respond to chemo when the rest of them have, so this could be personally useful. Plus, it's just good news for cancer patients in general.


Another general cancer research report with implications for lymphoma: Researchers think they have uncovered a communication pathway that allows the immune system to coordinate and fight off cancer. They speculate that when that sytem breaks down, cancers are allowed to grow. It's a theory I've read about before: the body is constantly developing mutated cells, and constatntly fighting them off, and when they can't fight them, they turn into cancer. (It's a theory that's hard to prove, because we only see the failures of the system.) According to these researchers, that failure of the system comes from a breakdown in the interferon pathway -- that communication system in the immune system. Once that pathway breaks down, the system can't fight off developing cancer cells on its own. This is important for lymphoma research because it might explain why lymphoma vaccines, which seem so darn promising, haven't had the expected results. Maybe accounting for the interferon pathway problem will result in a more effective vaccine. I know the lymphoma specialist, Dr C, that I saw when I was first diagnosed, was very excited about the vaccine approach. So maybe in a few years we'll see it work.


This next one is more directly lymphoma-related. It's from a press release describing a Journal of Clinical Oncology article on early clinical trials of Veltuzamab, a monoclonal antibody that could be an alternative to Rituxin. Like Rituxin, it targets CD20 proteins on lymphocytes. But here's the key difference: Rituxin is made from both human and mouse proteins, while Veltuzamab is made from only human proteins. As a result, it's likely to create fewer rejection problems than Rituxin. Rituxin is usually given very slowly, often over a period of up to 8 hours, and with Benedril, so any adverse reactions can be taken care of immediately. Veltuzamab seems to cause fewer of these allergic reactions, and so can be given much more quickly. The responses to it are otherwise similar to Rituxin. The same company is also running trials for another antibody, Epratuzumab, that targets CD22 proteins, and has been used effectively in a recent trial. My guess is this company will soon start to combine Epratuzumab and Veltuzamab and see how that works as eithera first-line therapy or as a Rituxin substitute for standard chemo regimens. But that's just a guess....

Veltuzamab isn't the only humanized monoclonal antibody out there in trials. Another company recently started clinical trials for its humanized monoclonal antibody, known as R7159. (You can tell it's still in trials because the marketing department hasn't given it a cool name with an X or a Z in it yet.) This one is similar to that other one with a Z in the name -- derived from human proteins, so there's less chance of rejection or allergic reaction. Initial trials for R7159 look very good -- at least comparable to Rituxin, maybe even a little more effective. I'm not privy to the science behind all of these antibodies, but it seems like they all have slightly different, and they claim slightly better mechanisms for identifying and attaching to CD20 (or other) proteins on lymphocytes.

More soon.

Radio Show

A couple of posts ago, I wrote about a researcher's crusade to get Zevalin and other RadioImmunoTherapies used more widely. One of the people in my support group, Betsy de Parry, was mentioned as being an inspiration to the doctor because of her success with Zevalin.

Well, Betsy did a nice spot on a radio show called Cancer Corner (the host, Bob Grayson, is himself a lymphoma survivor). She's actually written a book called The Roller Coaster Chronicles, which gets into the physical and emotional issues that she and her family have dealt with. She's a follicular NHL patient, too. She tried two fairly heavy chemo regiments (CVP and CHOP), and neither worked. But Zevalin did, and she's been cancer-free since 2002 (an almost 7 year remission).

The radio interview is about an hour long. The first part is focused on her book, being a survivor, caregiver issues, and other emotion-related issues. The second part gets into Zevalin and RadioImmunoTherapy. She gives a really good explanation about 34 minutes in as to why RadioImmunoTherapy is not used very frequently.

It's a nice interview. Click here for the Cancer Corner show, then click on "Last Recording" to listen.

Woof

There are a ton of recent articles that have come out lately on new and developing treatments for NHL, and paticularly for follicular NHL, and a few more that review and update what we know about current treatments. I'm still trying to read through them all. Once I do, I'll provide some links and summaries. There's a major conference on cancer research in the next week or two, so that's probably where a lot of this stuff is coming from.

For now, here's a fascinating article on how some researchers are studying lymphoma in dogs to better understand how lymphoma works in humans. It's from Medical News Today, and it's called "Collaboration Between NC State And UNC Lineberger To Combat Non-Hodgkin Lymphoma In Human And Canine Patients."

Pretty interesting. Right now, when researchers want to study a lymphoma treatment, they first try it out on mice. (This isn't only the case for lymphoma, but for many cancers.) It's been successful so far, but researchers are discovering that dog lymphoma is not only very common, but genetically similar to human lymphoma. So canine oncologists and human oncologists are teaming up and comparing notes. (By "canine oncologists" I mean those who study cancer in dogs, not those who are dogs. You probably knew that.) Dogs are more genetically complex than mice, and closer to humans, so they make a better model than mice.

Strudel is looking over my shoulder, begging to add some commentary, so to stop her from digging her nails into me any more, I'm going to let her add soemthing.

Surprising? No. Once again, dogs come to the rescue. You would be lost without us. And I'm not even talking about little Timmy and Lassie. I think "canine oncologists" shoud mean dogs who are oncologists. Then we'd see some breakthroughs. Talk about celebrations. We'd see some leg-humping that ni

OK, we're good.

More on all that great research soon.

200

Woo Hoo!


This is my 200th post to the Lympho Bob blog. An event worth celebrating -- at least until you look back at post #1 and realize the only reason I started a blog in the first place was because I was diagnosed with cancer.


So it's kind of bittersweet. But we focus on the sweet around here, not the bitter, so we're celebrating. (Speaking of bittersweet -- chocolate is the Official Antioxidant-Rich Food of the Lympho Bob blog. I recommend Dove Promises Silky Smooth Dark Chocolate.)


I noticed about two weeks ago that I was getting close to 200 posts, so I've been trying to come up with some way of marking the occasion. I don't think I could write about (let alone actually do) 200 of anything, so I've been reflecting on some Lympho Bob - related 200's:


I thought maybe I'd post something from the film musical 1776, which came out around the time of the country's 200th birthday, and which prominently features John Adams, the Offical Founding Father of the Lympho Bob blog. (See the entry from last June for more on my trip to Philadelphia).


I also thought about doing something involving a 1980 baseball card of Jim Rice (Official Baseball Hall of Famer for the Lympho Bob blog), which was number 200 in the Topps catalogue that year. It's available on eBay for under $2.00, which is astonishingly cheap for a Hall of Famer, considering he had 200 hits four times in his careeer. It's a clear sign of the recession. See the entry from January for my rejoicing reaction to his HOF announcement.


I had also thought about the 200 guests at the Marriage Vows Renewal ceremony for Snoop Dogg (Official Rapper of the Lympho Bob blog) and his wife Shante. Snoop was moved to tears at the ceremony, as was I when Peter saw Snoop in the mens room at Planet Hollywood in Times Square. See the entry from last May.

I could write a lot about Joe Andruzzi -- Official PAL (Pro Athlete with Lymphoma) of the Lympho Bob blog: alumnus of Southern Connecticut State University (just named to Southern's Athletic Hall of Fame); winner of three Super Bowl Rings with the New England Patriots; survivor of Burkitt's Lymphoma, an extremely aggressive form of NHL; fellow blogger; and winner of the Patriots' Community Service Award for doing things like bringing 200 inner-city kids to a Pats game and making sure they each got a Christmas present. See the Nodes of Gold entry from last June, where I named Andruzzi my second favorite PAL behind Jon Lester, but since Andruzzi started his own foundation to raise money for cancer research, he moves ahead. For now. His foundation sponsored the Joe Andruzzi Foundation Motorcycle Run to raise money for cancer patients. Hey, speaking of motorcycles.....

Post #200 has me thinking about a trip from Hamden, Connecticut to Cooperstown, New York this summer. According to Mapquest, it's a little over 200 miles. I plan to attend Jim Rice's Hall of Fame induction. Tickets are considerably more than $200 on StubHub. But that doesn't bother me, considering my brother, in a comment to the post on April 25, 2008, said he'd pay for my ticket to the induction ceremony if Rice got elected. (And he didn't object to my suggestion that he drive me there on his Harley, so I assume that's still part of the deal...)

Anyway, 200 thank you's to all of my readers, the family and friends that were my original audience, and those I've never met, but who are bonded to me by a common fate. There have been many times over the last 16 months that writing in the blog, and reading your responses, have been an emotional rescue. I'm glad I've been able to help out some of you, too.

Zevalin

Saw this article about Zevalin, and thought it was kind of cool. Actually, it's not about Zevalin so much as about a doctor who's making a push for Zevalin to be used more often.

Zevalin, as long-time readers know, is essentially a radioactive version of Rituxin. Liquid cancers like Lymphoma don't respond well to traditional radiation treatments because the cells won't hold still and keep moving through the blood stream. Zevalin takes a monoclonal antibody, which targets and latches on to the cancer cells, and uses it to deliver a dose of radiation to the cells, wiping them out. It's been a pretty successful therapy for lots of people, and is especially used by those who were unsuccessful with a stem cell transplant. Zevalin delivers hope along with that dose of radiation.

The problem with Zevalin is that it's complicated to administer; you need a team of people familar with both oncological practices and radioactive medicine, and the insurance issues are apparently complicated, too.

But as the doctor in this article (his name is Roger Macklis) points out, it's worth it. He's been trying to get more oncologists to try this treatment, particularly by pushing it in combination with traditional chemotherapy. The logic, I think, is that oncologists are familiar with chemo, so the combo may make it all seem a little less radical. The FDA is considering the Zevalin/chemo combo for approval, and will make a decision by July.

Macklis calls Zevalin (and Bexxar, another RadioImmunoTherapy" a "classic disruptive technology," something that makes us completely rethink how we approach something because the new approach is cheaper and better. He came to this conclusion because of his experience with a patient named Betsy (who is, coincidentally enough, a member of my online support group).

Zevalin has been passed around some, with different companies owning the patent, because it's had some trouble becoming accepted (and thus becoming profitable). I've written about Zevalin before -- its effectiveness, its problems, and my fear that it will be allowed to die off from lack of use. It has survived a few times in the past because of FDA approval for expanded use. Here's hoping that happens again in July.