We wanted to post a quick update on our news of nearly two weeks ago. Earlier this week, Brad had a liver biopsy, and on Friday afternoon we got the results, which confirmed indeed that he has a new kind of cancer. This time, it’s a diffuse large B-cell lymphoma, which is a fairly common type of lymphoma but in his case is a post-transplant lymphoproliferative disorder, prompted by his Epstein-Barr viral infection. His oncologist is proposing to treat it with rituxan, an antibody therapy that has been very effective against B-cell lymphomas. (In general, there are more effective treatments out there for B-cell lymphomas than for the rarer T-cell types, so that’s a glimmer of good news.) Rituxan is usually better tolerated and less hard on the body than traditional chemo regimens, an important consideration given Brad’s weakened post-transplant state.

Treatment should start next week, and given how fast this new cancer has been growing we are both very glad they have a plan and are moving quickly.

Dear friends and family, we had hoped that we could let “no news is good news,” from the last post, stand as the last-ever update on this blog. We are terribly sorry to say that isn’t the case. There’s news, and it is not good. Yesterday, we learned via a PET scan that Brad has more evidence of cancer. We are awaiting a biopsy to confirm the diagnosis, but his oncologist believes it is almost certainly a new type of cancer, a B-cell lymphoma called post-transplant lymphoproliferative disorder. It is caused by an Epstein-Barr viral infection, which his immune system (suppressed by the post-transplant medications) cannot fight effectively; the B cells proliferate aggressively (hence the name), causing tumors. This is a rare, but known, complication of immune suppression after transplant and is more common in solid-organ transplants.

Needless to say, this was the very last news we wanted to hear or have to share. Brad’s course of treatment is not yet certain, pending the biopsy. It is, however, clear that a very difficult road for our whole family lies ahead. We are grateful for all your good thoughts.

—Brad and Kate