Introduction

"How long would I have lived if I hadn't driven myself into hospital?" I asked.

"Maybe about another two or three weeks, it's hard to tell," my consultant replied.

That revelation was like a slap in the face. Everything else that was swirling around my mind; being a cancer patient, the length of time I would be in hospital, chemotherapy and its awful side effects, the fear of not achieving remission, all collapsed into a single moment of clarity - there was no choice but to start treatment.

That meeting took place in early December between my consultant, girlfriend Poppy, my parents and sister.

On reflection the early days were overwhelming. I was a fit and healthy 25-year-old, who doesn't smoke, has no history of cancer in the family and has a job I like. It was hard to understand why all this was happening and to comprehend the difficult times that lay ahead.

More bad news

The chemotherapy seemed to be going well but then my doctors got a letter from the genetics laboratory.

Prior to treatment a sample of my bone marrow was taken from the back of my pelvis. If you lean forward and put your hands just above your waist, the slight bony lumps either side of the spine, is where they tend to take it from.

This is sent away for thorough genetic analysis. The bad news for me was the tests showed I had a second type of chronic leukaemia.

In an earlier blog I described that my diagnosis took quite some time. This was why. Under the microscope I had indications of both Acute Myeloid Leukaemia (AML) and a chronic type too. At the time, the conclusion was that a chronic leukaemia had evolved into an acute one.

These results showed both were working at the same time.

My consultant, who is a world expert, trawled through all the medical literature and could find no one with the condition. He later got in touch with his global counterparts and heard that there maybe five patients with a similar condition in Germany but that nothing had been reported officially.

As such, he said he could no longer offer me an accurate prognosis but was keen to push on with treatment. The concern now was whether the two types of leukaemia were interacting and if so how. The belief was they probably were and that the chronic form, which could have been grumbling on for years, finally triggered the acute outbreak.

The chronic problem, as illustrated below, is occurring further back in the marrow, around the level of one of the stem cells from which the other cells originate.

Chemotherapy may or may not wipe out these earlier cells. Just how much of a problem they were remained to be seen. But the good news was that if the chronic cells were limited in their abnormality then they could be managed with a new drug called Glivec.

This drug has been hugely successful in treating Chronic Myeloid Leukaemia (CML). It works by inhibiting the effects of the mutated cells and seems to be effective for many years.

The plan was to crack on with the chemotherapy, achieve remission and then monitor the chronic problem. If it became an issue then treat with Glivec.

Needless to say being diagnosed with two types of leukaemia was a bit of a blow yet bizarrely my ego was purring at potentially being a sort of 'world first'. If only it had been in something slightly less life threatening.