The Anxiety of a Bone Marrow Biopsy

Any of us who has a blood cancer are likely to have undergone at least one bone marrow biopsy. According to the Mayo Clinic, this is a procedure where the doctor goes into the back of the hipbone and removes a small amount of liquid marrow. Then the doctor removes a small piece of bone tissue and the enclosed marrow.

I am used to the procedure itself, but will never get used to the anxiety of awaiting the results. All cancer survivors go through this anxiety, no matter what type of cancer has been diagnosed. For some people, it is the mammogram, for other people a scan or an MRI. Each person has a test where they dread the results. For people with blood cancers, it is the bone marrow biopsy. We all have shadows over our heads.

The biopsies can be done with a local anesthetic applied to the area or under sedation. I am chicken and prefer the sedation. While not totally under, I am not aware of what is happening, and I do not want to be. Of course, I need a driver, and cannot go anywhere for a day. The nurses tell me to be a couch potato, which doesn't sound all bad.

When I was initially diagnosed with cancer, it was from a biopsy. Blood work showed nothing. I started out 8 years ago having the biopsies done annually, but now I have them every six months. I know the drill better than the staff. The last time, I told the scheduler that I must arrive by 7:00, have the procedure at 8:00 and have nothing by mouth after midnight. She just smiled.

The procedure is done is on the second floor of the same hospital where the Cancer Center is. The nurses who work in the outpatient department are the ones who prepare me, administer the anesthetic under the orders of the doctor and do preparation and follow-up care. They are warm and wonderful, and I have the greatest respect for them. They all know me by name now.

I may be sore a day or two afterwards, but often I am not. The oncologist tells me it is chance where the needle goes into the hipbone, whether it will be easy or hard. In other words, it's a crap shoot - my words not hers!

This is the procedure part. What makes the bone marrow biopsies so difficult is the waiting for the results -the part I truly dread. The first results can be back in a week. But I have a condition where the 5q needs to be tested on the cells for progression of the myelodysplastic syndrome. Usually it takes two to three weeks to get all the results back from the laboratory, since they have to run special tests on each cell.

I often describe my cancer as a roller coaster. Sometimes I am in remission and celebrate knowing I will live and enjoy life a little longer. Other times, the cells are compromised. The abnormalities of the 5q have ranged from 30 to 90 percent being abnormal. If it is going upward, the chemo needs to be increased or changed.

Often, I have a sense of the news I am getting from how my body feels. I told my oncologist before one bone marrow biopsy that something was not right. Tests showed a large number of the cells were compromised and we switched from oral chemo to shots in the stomach.

I have another biopsy coming up soon. I know intellectually that the only way to tell how the cells are performing is the biopsy. I know the time will come when nothing works. Blood cancers are treated by chemo until they no longer work. I am older, and a bone marrow or stem cell transplant may not be possible. The psychological consequences of all of this are worse than the procedure. I have shared this feeling with my doctor who is fantastic and she "gets it."

Yes, I will be very nervous for good reason. But I also have to realize the past 8 years have had true quality of life, or as I have described to the doctor "a fun ride," I know there are always new drugs coming out. I have a wonderful support system. I have a wonderful doctor, nurses and medical people to take care of me and fight along with me. Truly, any of us could die on any given day from an accident or heart attack, and life is so very fragile. Meanwhile I need to be positive, not negative. I need to enjoy every single day. So - bone marrow biopsy here I come!