Martin Williams had his introduction to multiple myeloma nearly four years ago while reading a Reader's Digest article.
"It was a condensed version of "Going For the Cure," a book written by Francesca Thompson, an M.D. in N.Y.," Williams says. "She had been tested and was diagnosed with multiple myeloma."
In her book, Thompson tells of her decision to receive a bone a marrow trans- plant, the first multiple myeloma pa- tient to do so.
"I read the article and remember thinking what a tough disease." It was a very poignant story," Williams said. "Three weeks later I found out I had the same disease."
Williams, 46 and a resident of East Amherst, N.Y., had suffered from chron- ic sinusitus for 20 years. His allergy doctor thought he might have a gamma globulin deficiency and wanted to find the cause. At first, multiple myeloma was not believed to be the problem, since it's usually found in older people or African-Americans. But tests proved otherwise.
"Each test they performed-blood tests, urinalysis, bone marrow biopsy-point- ed to multiple myeloma," Williams said.
The diagnosis was confirmed in July 1990, the day before Williams and his wife were leaving for a vacation.
"I told my doctor we were going away on Saturday and asked if he could get the results before then," Williams says. "He called me at work on Friday and asked me to come to his office. It was 3 p.m., we were leaving for Maine the next day and I was swamped with work. I couldn't get away.
"But it didn't take a rocket scientist to figure out he wasn't calling me to come in immediately because he had good news. He said he, 'didn't want to blurt it out over the phone but. . .you have mul- tiple myeloma.' At that time I knew nothing about the disease, but I became very educated on the problem."
At the urging of his wife, Judy, Williams went to the Roswell Park Cancer Insti- tute in Buffalo for a second opinion.
"I got to Roswell in August and went through a workup that confirmed the di- agnosis," he said. "I was seen by a young oncologist who felt one advan- tage was that I was diagnosed very early stage I."
Williams was referred to Dana-Farber Cancer Institute in Boston and was given three options: I) do nothing until the disease advances except follow it and monitor it; 2) try low-dose chemotherapy so the disease doesn't progress; or 3) use higher dose chemotherapy and an autologous BMT (ABMT) to hopefully cure the disease.
"I started first on a low-dose chemother- apy of melphalan and prednisone, but I was a slow responder," Williams says. "Afterward I was further away from re- mission than when I started."
In January 1992, Williams decided to have the ABMT. He began a combined drug chemotherapy program that had a much stronger impact. In early October that year, he went back into Dana-Farber and underwent two rounds of high-dose chemotherapy and 3-1/2 days of total- body radiation. One week later he had his BMT, receiving his previously har- vested bone marrow which had been purged.
"It was a very simple procedure," Williams says. "They give it back as a simple IV that takes about a half-hour to 45 minutes.
"Before the BMT, I got involved in reading a number of books and articles and talked with people who had gone through the procedure. I was prepared for a more difficult procedure than it
was," he says.
He experienced some nausea, he says, but it was relatively mild. From the radi- ation he suffered a severe sore throat, heartburn and indigestion. But he says he had a good energy level throughout the transplant.
In mid-November Williams' blood counts had remained at a satisfactory level for a consecutive number of days and he was discharged from Dana-Far- ber.
Returning to Buffalo, Williams says he went to the hospital every three days to monitor his blood and receive platelets to ward off infection. He started steroid therapy due to minor lung complications from the radiation and chemotherapy. He developed pneumonia in February, but recovered and on March 7 went back to work as manager of physical security for the western region of Marine Mid- land Bank.
Williams feels his progress after the BMT is going well. His bone marrow biopsies look good, though he continues to take steroids for shortness of breath from lung damage.
"My quality of life is about the same as before the BMT," Williams says. His ac- tivities have not changed much, though he is easily winded because of the lung damage. He says he is now much more reflective about his life, "taking time to smell the roses."
Does he feel he made the right choice in having a BMT?
"I have an analogy, kind of like the head coach of a football team," he says. "You need to develop a lot of resources, gath- er a lot of information about what's available, and develop a game plan that will work for you. It depends on age, general health conditions, financial situ- ation.
"I took the proactive approach to it," he says, "I opted for a transplant in hopes of a longer life and cure."
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