Yes, it was time for another opinion from…City of Hope.  I guess not-much-news is good news, but there’s not much to say.  They reviewed all the data and set me up with a doctor.  What he had to say:

• I’m getting the right treatment…CHOP-R is universally prescribed for both High Grade Follicular and Diffuse Large B-Cell Lymphoma
• I seem to be doing well based on the original infection area around my ribs getting less painful and my blood counts improving
• Stem cell therapy isn’t called for – this would only be indicated if I relapse after my initial remission
• Based on where I seem to be infected, there is no strong indicator of central nervous system (CNS) involvement, which would require a separate, concurrent intrathecal course of chemo in my spinal fluid.  While my bone involvement is atypical and a bit mysterious, Intrathecal treatment would still be an elective prophylactic treatment (see me using the big med-tech words!) for which there isn’t strong scientific evidence of effectiveness/need.
  • One more good thing: the doctor at COH will review my case during their weekly debrief on new patients – all the lymphoma experts review new cases…so maybe I’ll hear something else on Thursday.

Interestingly, visiting City of Hope and this new doctor made me feel even better about my local doctor.  I thought there was a chance I’d be blown away by some incremental expertise and resources at a place like COH, but that just wasn’t the case (at least not with who I saw).

Bottom line: I stay the course and wait to see the results of the body scan after chemo cycle 4 in mid- to late-September.  If the bone lesions aren’t seriously reduced, then we’ll need to seek out additional, specific expertise and determine what other diagnostic and therapeutic procedures might be warranted. In the meantime, I’ll research the Intrathecal Chemo a bit more and might decide to proceed with it.