SAN ANTONIO – The highest doses of chemo and a stem cell transplant have finally left Bexar County Sheriff's Office Deputy Brandon Rivas in remission.
The transplant has the potential to eventually cure Rivas' rare form of lymphoma. Even the tiniest changes are huge signs of improvement for him.
"Sportin' a little bit of hair now," Rivas said, belting out a loud laugh.
Laughter has been hard to find since he was diagnosed with anaplastic large-cell lymphoma.
"My energy level is not what it used to be, but overall, I feel 100 percent better since I was diagnosed," Rivas said.
"To get back in shape again just takes time," said Rivas' hematology and oncology specialist, Dr. Paul Shaughnessy, with Methodist Hospital, as he sat with Rivas Wednesday for a checkup.
Time now isn't such a frightening word since Rivas' stem cell transplant on Nov. 8.
Shaughnessy needed to heavily boost Rivas' chemo to eliminate any remnants of cancer.
"He was at a very high risk of relapse," Shaughnessy said.
The downside is that heavy dose of chemo destroys bone marrow. That is why in these cases, Shaughnessy pulls healthy bone marrow stem cells from either the patient or a donor before treatment starts.
Doctors at Methodist Hospital extracted blood through a port in Rivas' neck. Once the bone marrow stem cells were separated, they were frozen and saved. For two weeks, Rivas underwent the extensive chemo treatment, spending 21 days in the hospital and dealing with severe side effects.
"Then when chemotherapy is done, we take those bone marrow stem cells out of the freezer. We unthaw them, goes right through an IV. The stem cells go right through the bloodstream. They know to go in the bone marrow, plant, like, seeds, and regrow all the bone marrow over about two weeks," Shaughnessy said.
Rivas had healthy bone marrow before he started the high doses of chemo and was able to use his own stem cells.
"I couldn't imagine having to wait months, years. I mean, I was very lucky and fortunate," Rivas said.
So many cancer patients have damaged marrow and need donors who perfectly match their genes.
"We still see people who can't find a donor, don't get to transplant and their disease can take their life. Many of us don’t have matches in our family so then we have to look in our registry and find donors out there," Shaughnessy said.
It's extremely easy to give a sample. Anyone can pick up a swab kit at a blood donation center or have one sent from a donor website, such as www.bethematch.org, www.gencure.org or Methodist's website. All that's needed is a swab rubbed on the inside of the cheek, and the sample can be sent in to become part of the international Be the Match registry.
People who are found to be a match are not obligated to then donate stem cells. However, Shaughnessy urges anyone who is a match to speak with a doctor about what the life-saving donation entails. He said in most cases, the stem cells are taken from a donor through blood. An IV is inserted, and it’s a quick donation. In more rare circumstances, doctors will extract the marrow directly from the hip in a low-invasive procedure.
The transplant Rivas received could lead to a lifetime of remission, a chance every patient deserves.
"We do cure some people of these cancers when we can do the transplant, so it’s a great thing when we have the donors and can do it," Shaughnessy said.
Rivas will have a PET scan in February to make sure he's in remission. He hopes he can return to work around then and continue serving his community.
Rivas is not the only local first responder whose survival depends on this type of transplant. San Antonio police Detective Roland Perez has a chronic form of leukemia. His doctors need to perform the same bone marrow stem cell transplant.
Unlike Rivas, Perez's marrow is not healthy enough to use, and his family members are not matches. The community has spent months rallying for donors to sign up, hoping they can find a life-saving match for the 20-plus-year police veteran.