11 Oct 2006

To All,

On Monday, we met with doctors at the University of Minnesota Medical Center and they left us with 6 options, in order of preferred treatment.

• The first option is known as a Donor Lymphocyte Infusion (DLI) - which according to the Doctors would be most preferable in Cheryl's case. In addition, they were certain that this procedure could be performed at Madison.
  
• The next two are variations on the same treatment known as Killer Cells. Which is only available in Minnesota.
  
• The fourth treatment is with the use of an Isotope type cell that (radioactive) that is infused, which the cancer cells respond to by ingesting. Once ingested the Isotope will kill the cancer cells
  
• The fifth treatment is modifying Cheryl's immune system, or re-educating, to recognize the cancer cells and kill them.
  
• The sixth is to do nothing at all. This would only be a matter of time as to when the cancer returned.

The treatments listed above, the first five involve various forms of additional chemo therapy. The first one is less invasive than the rest. The second and third are current clinical trials, but are very hard on the body. The fourth and fifth are experimental and the doctor wouldn't really recommend them.

The doctor told us that with the exception of the last option, the chances of successfully curing Cheryl are between 20% - 30%. The doctor wasn't certain Cheryl could handle treatments 2-5 as her body has already been through a great deal and may not handle the additional strain. In addition, the one thing that all the doctors agree on is that in order for the treatment to be successful, Cheryl must experience some Graft versus Host disease, which she didn't on the first transplant. Graft versus Host disease can be as mild as a rash or fevers or as deadly as major organ damage.

Tuesday, on the way home, we stopped by to see the doctor in Madison. She is confident that they can perform the DLI at Madison, but needed to talk with the doctor at UMN medical clinic to make sure she fully understands his recommended treatment. We should have a plan of how we will proceed by the end of the week.

To be honest, we are uncertain of the proper course and location of treatment. Please pray in the following areas:

• That by the end of the week the right treatment and location will be known - both doctors agree that time is of the essence
  
• That God continues to place his strength and healing touch on me and the rest of the family
  
• That what ever treatment is determined to be the correct action, that I can handle both the physical issues and the hospital stays.

Love in Christ

Cheryl and family