I’m starting this blog mainly to keep friends, colleagues and family up to date on how I’m doing, but I’d better provide a little background since not everyone knows the whole story. Skip ahead if you do! I’m Selena and I am 45 years old; have been married for 24 years to a sweet man who can fix and build almost anything and we have two really wonderful sons, who are currently 12 and 15. They are going through all the acne, social struggles, sibling bickering, and eye-rolling that teenagers usually do and I love every minute of it! I have worked for over 20 years at various companies running clinical trials which test experimental drugs in humans. For most of those years, I have worked with cancer drugs, monitoring and managing studies of drugs that we hoped will help patients who have cancer… lung cancer, breast cancer, ovarian cancer. I like the biology of cancer and I enjoy working with the physicians and nurses in oncology more than other therapeutic areas- there is much less golf and more hard work and much more of a collaborative spirit. Five years ago, I started working at a small biotech company based in Colorado, which had several interesting potential drugs. They assigned me to work on a trial with multiple myeloma patients. Myeloma is a pretty complicated cancer to understand. It is actually a malignancy of the plasma cells, which reside in your bone marrow and make immunoglobulins. Malignant plasma cells not only overmultiply and hog all the space in your bone marrow (preventing your marrow from making other blood cells) , they also make abnormal immunoglobins, which affects your immune system, and they secrete compounds that affect your rate of bone turnover, causing lesions throughout your skeleton. Nasty cancer. Used to have a horrible prognosis but in te last 15 years, there have been a couple really important breakthroughs and patients have a lot more treatment options. It is now considered treatable but not exactly curable- most patients respond well to the drugs but eventually relapse. So, since 1997, I’ve been reading myeloma patient charts, helping the summarize data from the trials, and have learned quite a bit about this rather unusual disease. I was completely floored this year when a low white count in my annual physical in December plus some anemia when it was repeated, turned into a myeloma diagnosis in January. How could I have myeloma? I’ve always been healthy as a horse- don’t even have high cholesterol. I had all 4 of grandparents alive into their 70s and 80s! And myeloma is a cancer more prevalent in people in their 60s, men, and blacks? I had one really bad, really depressed weekend while I came to terms with the realization that I actually was NOT healthy, will never retire, will probably never see my grandchildren, and may not even see my sons get through college (this really worries me, since I earn the only salary in my family). Then, with the wonderful support of my family, I put it behind me, and got started at Duke on my induction therapy. For about 5 months, I’ve been juggling work travel, family stuff, getting to Duke for subcutaneous Velcade injections, along with taking oral Revlimid, and an oral steriod, dexamethasone. This “RVD” regimen is extremely effective , with almost all patients seeing 75-100% drop in their disease markers. I was lucky enough, not only to respond , but have had a stringent complete response, which means the myeloma is now not detectable by most of the standard measuring techniques. Overall, not many side effects, either. Some sneaky cells are still there though, so the next step is a high-dose chemotherapy supported by an autologous stem cell transplant. It takes a few weeks to prepare for the transplant. I took a dose of cyclophosphamide (a chemo) about 19 days ago, which pushed my body to start making lots of stem cells to replenish my marrow. Then I also injected myself with growth factor drugs that stimulate even more stem cell production. On the 1st, 2nd, and 3rd of July, I had apherisis and they collected 11.7 million cells/kg from me. That is a lot of stem cells! Enough for me to do this 3 times, if necessary. On the 4th of July, all my hair fell out from the chemo. Oh well- now I look like a cancer patient! After a nice long weekend with NO drugs (yeah!! I could have a beer at a Durham Bulls game), today, I packed up and moved into a small furnished apartment near Duke. Tomorrow, I receive the high dose chemotherapy- 200mg/m2 of melphalan, a very old, traditional chemotherapy, highly myeloablative (kills the marrow). Not looking forward to it much but it will be good to get it over with and see how it feels. I’ll try to get a picture of the lethal stuff and post it with my next blog, assuming I can figure out how to do that!