Trying to condense as much as possible. Location-wise, I'm kind of dependent on the doctors we have here in the area and age-wise I'm kind of "accepting"
Questions are listed after the background info.
Plasmacytoma surgically removed in December 2012 and corpectomy; in general pain free since. Radiation in Feb/March caused swallowing problems and thrush. Now going on Zometa monthly. Have occasional pains under chest, rib, and back. Prefer palliative care but open to low dose chemo. Dr. seems to use standard VRD protocol, I'm not open to it. Had Radiculopathy and am refusing Velcade. Open to Revlimid and Dex. (see Qs below)
Only had E-Pep, U-Pep, CBC and skeletal xrays in January 2013. Didn't want a BMB, already donated bone from the left hip - for my neck - and m. myeloma is clearly indicated by the plasmacytoma cancer-biopsy together with the subsequent xrays and M-spike.
Some of my #s are:
CBC almost totally normal except for Total protein 10.9 and very very borderline anemic. Per xray a few lesions.
Immunofixation shows IgG monoclonal protein with kappa light chain specificity;
S-Pep M Spike 4.5; IgG 7434 mgl/dl and IgA 36, IgM 26;
ISS II.
Wanted my onco to run new tests prior to starting on low dose chemo; he said we could do that AFTER I've started chemo.
Questions:
1) What tests should be a MUST prior to chemo? When and how often should I have follow up tests? I will stay on top of the tests required by Zometa/Revlimid/Dex guide lines.
Are the Jan. 2013 tests good enough as baseline?
2) If and when I start: Is 25 mg Revlimid daily and 20 mg Dex per week; 2 weeks on and 1 week off (yes!) acceptable for non-agressive treatment? Better Suggestions? I am 67 years old and not interested in SCT.
3) Should I start on chemo in a week or two or wait till I'm more symptomatic? (the latter would be my choice)
4) Could a FISH be done on my CD138 stain from the plasmacytoma? In my case (and for my purposes)would FISH be helpful?
I'm grateful for any and all replies.
Kate
