Some of R’s blood work numbers have improved, others are unchanged, and one dipped below normal. Despite the mixed bag, we’re happy with the most recent test results from July 24^th.

First, his *LDH (lactate dehydrogenase) went down significantly. It’s been between 400-700 since his diagnosis, and this time, it was 399. It should be less than 210. It’s still high, but a lot less so than before. If you want to know what LDH is and how it affects cancer patients, see below.

Next, his spleen shrank. Yay! The last time he had an ultrasound, it measured 25 cm with a 2200 volume. An average size would be less than 12 cm with a 334 ml volume or less. This time, it measured 20 cm and 1574 ml. As a result, R feels less pressure in his abdomen. Again, much too large, but smaller than before.

R’s anemia indicators (primarily hemoglobin and hematocrit) stayed about the same. In his case, both are too low. His platelets went into the abnormally low range this go-around (meaning more potential for internal bleeding because platelets allow your blood to clot), but the doctor didn’t seem overly concerned.

These results are from a snapshot in time. They could change for the better…or worse the next time R has lab tests. His numbers tend to jump around. We remain cautiously optimistic.

What does all this mean? We’re trying to slow down the disease. When it progresses, he’ll need a bone marrow stem cell transplant, which can be dangerous and even fatal; however, catch-22, it’s the only known cure. Symptoms of disease progression include:

• Severe fatigue
• Drenching sweats
• Irregular heartbeat
• Rash
• Bleeding in the stomach, colon or esophagus, caused by increased blood pressure and low clotting factors
• Pain in the belly from the spleen getting bigger (as it tries to manufacture blood cells when the bone marrow turns into scar tissue)
• Signs of leukemia, such as bleeding from the gums or nose, severe bone pain, frequent infections, and overall weakness, among others

SECOND OPINION AT MD ANDERSON IN HOUSTON

We’ll head to Houston for a consult with a specialist at MD Anderson in October. Our insurance does not pay for out-of-state treatment or doctor visits unless it’s classified as an emergency. We’ll pay out of pocket but only for a consult. MD Anderson won’t conduct tests—they’ll use Fred Hutch records. We’re completely satisfied with Hutch, but a second opinion can only be a good thing. The more we know, the better. It’ll give us some peace of mind.

*One of the hallmarks of cancer cells is increased energy requirements associated with the higher rate of cellular proliferative activity. Metabolic changes in rapidly dividing cancer cells are closely associated with increased uptake of glucose and abnormal activity of lactate dehydrogenase (LDH), which regulates the processing of glucose to lactic acid. As serum LDH levels were found to be commonly increased in cancer patients and correlated with poor clinical outcomes and resistance to therapy, the determination of LDH has become a standard supportive tool in diagnosing cancers or monitoring the effects of cancer treatment.