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Pathways to Discovery: Summer 2012

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UCCCC Lymphoma Experts Address Challenges of Treating Slow-Growing Cancer

What started as a lump on his eyelid took Bill Meyer down an uncertain path. The 61-year-old Sugar Grove, Illinois native was surprised that a biopsy revealed a somewhat rare form of non-Hodgkin lymphoma.

“It scares the bejeebers out of you when they say you have cancer,” said Meyer, president of his own wholesale plumbing supply company. “Nobody says it’s not life threatening, but nobody says you’re definitely going to die in a year, either.”

At first, Meyer’s specific subtype of non-Hodgkin lymphoma was unclear, but eventually he was diagnosed with marginal zone lymphoma, which is often associated with autoimmune complications. The challenge then became figuring out which came first and how aggressively to treat the slow-growing, or indolent, cancer.

Diagnosis and Treatment
Marginal zone lymphomas are often driven by bacteria, and because prior studies reported that antibiotics can be helpful, Meyer was treated with a course of doxycycline. His symptoms improved to the point that he was in remission for 2 years.

“As we learn about what drives cancer,we have found that some lymphomas can be related to environmental factors, like bacteria, and resolving that irritant might be helpful,” said Sonali Smith, MD, associate professor of medicine and director of the Lymphoma Program at The University of Chicago Medicine.

In January 2011, Meyer was admitted to the emergency room with a depleted level of red blood cells known as hemolytic anemia. His hemoglobin count was a mere 5 grams/dL, which is dramatically lower than the normal 13 or 14 grams/dL. He was treated with prednisone, a steroid, and rituximab, an antibody therapy. On this treatment regimen, Meyer said he experienced no side effects, often eating a full meal and playing golf immediately after treatments.

A Successful Outcome
Meyer is pleased that the word-class hematopathologists at UChicago were able to identify his subtype of lymphoma and felt confident in his doctor’s ability to treat it.
“I would urge anyone who discovers they have cancer to go to The University of Chicago [Medicine],” he said. “You’re going to be seen by somebody that specializes in just the disease you have.”

Meyer had to undergo another course of rituximab, but remains in remission since last summer. He is now being monitored to make sure his blood counts stay within a normal range.

“A lot of people stress the importance of finding a cure, but in my opinion, research is going to lead to a point where cancer is a manageable disease, like diabetes,” Meyer said, who also credits his wife and family for supporting him through his diagnosis and treatment.

Dr. Smith said with indolent lymphomas, there is often no need for therapy unless the patient develops symptoms or abnormal blood counts. She added that she often forms close relationships with her patients who have slow-growing cancers, as they meet regularly to check for changes in the lymphoma and carefully weigh treatment decisions, often over a course of many years or even decades.

“He’s done incredibly well. Our hope is that he continues to do well and that we can continue to build a solid relationship,” she said.

 

Ernst Lengyel

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