It has just been over a year now since being told I have Small Lymphocytic Lymphoma/Chronic Lymphocytic Leukemia  (SLL/CLL). I guess I can say that I still feel the same today as I did the day I was told. I am more aware of what I have now, which makes me more careful of where I go and who I see. One example was not going home to spend Christmas with my grandchildren in 2011. Christmas in the north, I mean north, as right on Canadian border, is the time of year that most of my children and grandchildren get some virus. Now that I know my immune system is not functioning at full throttle, I tend to move to the careful side when making decisions. My nose bleeds more than usual, but being it is quite dry here right now, one may expect that. I really don’t get very tired, I can’t run, but when walking or working around the place, if I take my time, I am fine.

I did go golfing last week to an 18 hole golf course. Those who I was with, wanted to walk, so I said okay. I was only able to go nine holes. I have to admit, at the ninth hole, I was beat, my ankles hurt, and I was breathing heavier than usual.  I also noticed that I have lost some strength over this past year, I try to do strength exercises, but it is not as easy as before.

However I continue to ride my motorcycle, or I should say, I did. After a month of trying to figure out why the bike wouldn’t start after a short ride, I finally figured out that the stator was bad. I was going to fix it myself, but decided not to, as I really have no place where I could tear the lower part of the engine apart, and work on it. So I took it to my friendly local motorcycle shop, where they confirmed that my diagnoses was correct. They have been working on it for the last four days. I hope to get it back tomorrow, Tuesday. I have a doctor’s appointment Friday, so I really hope to have it by then.

My wife has a friend that just found out her mother was diagnosed with Melanoma (skin cancer). I wanted to see what new therapies were available for this very serious and deadly cancer. Here is one article I found that may be of interest to some.

On March 25, 2011, the Food and Drug Administration (FDA) approved a breakthrough melanoma treatment called Yervoy (ipilimumab). Not only is this the first melanoma drug to receive FDA approval in 13 years, but it’s the first therapy proven to extend overall survival for advanced stage melanoma patients. According to the best estimates, Yervoy may offer many patients a 2-year survival advantage, with a smaller percentage of patients being virtually cured.

Melanoma is the deadliest form of skin cancer. When discovered early, it can usually be cured with surgery alone, but once it spreads (metastasizes) throughout the body, treatment options are limited. After decades of frustration for researchers, however, this promising new therapy is providing hope.

Yervoy (Ipilimumab) is a monoclonal antibody, an immune protein that binds to a molecule called CTLA-4 and inhibits it from functioning. CTLA-4 is a kind of brake on the immune system which keeps it from overfunctioning and thus attacking itself; by blocking it, ipilimumab kicks the immune system into higher gear so that it can identify, attack and eliminate melanoma cells. To read the whole article you can go to Skin Cancer Foundation. http://www.skincancer.org/skin-cancer-information/melanoma/melanoma-treatment/learn-more-about-yervoy

Now for my SLL friends, I may have posted this before, but if not, I believe it may be of interest to some, to SLL patients I’m sure it will.

Non-Hodgkin’s lymphomas (NHLs) are a very heterogeneous group of cancers that develop in the lymph nodes present throughout the body. There are over 25 subtypes of NHL, although most are diagnosed infrequently. Small lymphocytic lymphoma (SLL) is the third most commonly diagnosed subtype, after diffuse large B-cell and follicular lymphomas.

It accounts for 5 to 6% of NHL cases or approximately 400 cases per year in the United States. Although some NHLs are very aggressive in nature, SLL is considered an indolent lymphoma. This means that the disease progresses very slowly, and patients tend to live many years after diagnosis. However, most patients are diagnosed with advanced disease, and although SLL responds well to a variety of chemotherapy drugs, it is generally considered to be incurable. Although some cancers tend to occur more often in one gender or the other, cases and deaths due to SLL are evenly split between men and women. The average age at the time of diagnosis is 60 years.

Advanced SLL (some stage II and all stages III and IV) is considered incurable; therefore, the goal of treatment is symptom management. In patients with asymptomatic SLL without organ compromise, so-called watchful waiting is the first-line treatment of choice. Patients are closely monitored, and treatment is initiated only when meaningful signs or symptoms occur. The average time to treatment from diagnosis in these patients is 2 to 3 years. Indications for treatment of advanced SLL include: painfully enlarged lymph nodes, low blood counts due to bone marrow involvement, threatened organ function (such as the liver), recurrent infections due to suppressed immune function, and transformation to a more aggressive subtype of lymphoma.

Systemic treatment is standard-of-care for advanced, symptomatic SLL. This includes single-agent chemotherapy, combination chemotherapy, or chemoimmunotherapy, which is chemotherapy plus a monoclonal antibody.

First-line regimens may include the following:

  • Chlorambucil with or without prednisone
  • Cyclophosphamide with or without prednisone
  • 2-CDA: cladribine monotherapy
  • FAMP: fludarabine monotherapy
  • FC: fludarabine, cyclophosphamide
  • FM: fludarabine, mitoxantrone
  • FND: fludarabine, mitoxantrone, dexamethasone
  • Bendamustine monotherapy
  • CVP: cyclophosphamide, vincristine, prednisone

In advanced SLL, the addition of rituximab to any of the above chemotherapy combinations improves survival in patients. This medication is a monoclonal antibody that specifically kills B-cell lymphomas. It is synergistic with chemotherapy, meaning that the two types of medications work better together. Rituximab alone or with any of the aforementioned chemotherapy is therefore considered standard first-line therapy for SLL.

For those few of us who have SLL, you can read the entire article at http://www.knowcancer.com/oncology/small-lymphocytic-lymphoma/

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