It's a Monday morning, and I've spent most of my last 45 days researching every possible source of information on follicular lymphoma I can find online. I've read countless research papers and studies in magazines such as Blood, NEJM, the Journal of Clinical Oncology, and the database of records at the U.S. Department of Health's Pubmed Central. I've listened to podcasts, webcasts and presentations from the Lymphoma Research Foundation, the American Cancer Society's Blood CancerCast, and the American Society of Hematology (ASH) annual conference. I've joined forums and discussion lists at WebMagic's lymphoma.com board, and Yahoo groups for Non-Hodgkins Lymphoma, Follicular Lymphoma and the Lymphoma Vaccine. I've met literally dozens of people who have the same disease I do, asked them plenty of questions, and made friends along the way. I've memorized the names of noted follicular lymphoma authorities and institutions, and listened to the latest debates on treatment strategies.

In short, I've decided the best way for me to handle this beast is to find out as much as I possibly can about him. (I think of cancer as a person--a "he," specifically, for some reason. Cancer is not an "it" to me anymore, because I've grown to know him quite personally in the last several weeks. I've talked to a few people who have actually named their cancers, and talk about them as if they're acquaintances or rivals: "Well, I thought I got rid of Leonardo, but he moved back in last week according to my checkup." So I'm not crazy. Or, at least, I'm not the only one who's crazy.)

So, this morning, when I meet with a lymphoma specialist from Denver, I'm loaded for bear, as the old saying goes. This specialist is a very nice man, who sits down with me for two hours, going over treatment options and such.

We get off to a bit of a rocky start, because he's starting with the basics. Nothing wrong with that, but I'm way past the basics; I want to jump right into discussions about treatment options, his opinions on controversial strategies, and so on. Instead, he's telling me all about how Follicular Lymphoma is graded and staged. "Grade I is determined by--" he starts. I finish for him: "By looking at the path slide under a microscope and determing how many large cells are present. If fewer than five cells can be observed per high power field, it's Grade I. If it's 5-15 cells, it's considered Grade II. If it's a proliferation of large cells, it's Grade III."

He blinks and looks at me, then nods. Then he smiles, and says, "Watch & Wait is a very viable option in your case. But if we were to choose to treat, I'd go with R-CHOP chemo." From there, the conversation progresses nicely. If I'm doing chemo, he says, he'd like to see me enrolled in the Genitope clinical trial (which is an experimental vaccine). I ask him why he thinks I should go for the more aggressive R-CHOP rather than the "gentler" course of R-CVP, and he says he feels we should do as much as possible to get the disease into complete remission, and give the vaccine as much chance as possible to do its work. I ask him about Myron Czuczman and his cohorts, and whether or not he agrees that up-front anthracycline-based chemotherapies may reduce the risk of histological transformation in follicular lymphomas. He says he went to Czuczman's presentation of his findings at the ASH conference last November, and found Czucaman's thought's "provocative."

I ask about Bexxar radioimmunotherapy as an option. While he's not predisposed to Bexxar as front-line therapy, after he listens to me explain that I feel since Stage II is often curatively treated with localized radiation therapy, and since I'm basically a Stage II with very limited bone marrow involvement, Bexxar's effect of systemic radiation might replicate those results in my case. He considers, then nods and agrees Bexxar might be a good option in my case.

I ask if he feels we might need to start calling some people tentatively "cured" in the next few years, since we have patients treated with experimental therapies who are in remission 8+ years, and once those patients hit the 10-year mark, the rate of remissions seem to plateau, which is a recent occurrence according to studies at MD Anderson Cancer Center in Texas and...

He smiles again and interrupts me. "I think you have a pretty good handle on your options, Tony. In fact, I'd have to say you're the most well-read patient I've ever spoken to after diagnosis. You just need to decide how best to proceed."

This is a nice compliment. At least, I think it's a compliment; I prefer to take it as a compliment, in any case.

As an added benefit, this doctor has worked with the doctor I'll be seeing next week in Nebraska; he says he'll write up his notes from our meeting and forward them to her in preparation for my upcoming appointment, and ask her to send her own notes back to him after our consultation. I can only imagine what goes into those notes.

But, as Schoolhouse Rocky always said before "Conjunction Junction" rolled every Saturday morning of my childhood, "Knowledge is power."

It certainly is in my case. I'm looking forward, in an odd and geeky way, to my meeting with the lymphoma expert in Nebraska.