Now it's Paul's turn for some good news and some uncertain news. Paul's latest lab results showed that his chemo treatments have reduced his cancer to impressively low levels. What this means, however, is that now he is ready for a bone marrow transplant. The idea is that a transplant will be most effective when Paul's cancer levels are at their lowest. Although the chemo has reduced his cancer levels for now, the chemo won’t remain as effective and his levels will start climbing at some point. So, it’s best to do the transplant sooner rather than waiting.

The transplant will be done at Stanford University some time over the next few weeks or months. Fortunately, they don't have to search for a match to do the transplant -- a bone marrow transplant can be done with Paul's own cells. Paul's cells will be harvested, then he gets zapped with heavy duty chemo. Paul's harvested cells will then be re-introduced. If all goes well, the transplant procedure at Stanford will take about a week or so, and he's sent home to recuperate. Because he will have a much higher risk of infection during this time, he has to keep fairly isolated.

Most patients with multiple myeloma undergo one or more transplants over the course of their treatment. For at least a couple years or more, those who have had a transplant report much better quality of life. A transplant may also reduce or eliminate the need for additional chemo during that time. However, because currently the cancer can’t totally be eliminated from his harvested cells, some cancer cells are likely to be re-introduced, allowing the cancer to come back.

It’s going to be a challenge for the two of us to figure out how all this will work out. We’ll know more details when we meet with the medical team at Stanford some time over the next couple of weeks.