Switching On the Immune System

May 27, 2021

I’ll tell you one thing. Cancer treatment sure takes a lot of time! Today was a big day: CT scan to see if the cancer had spread, a visit to Dr. Oncology, plus, if there were no spread, infusion #1 of immunology treatment.

So the day began bright and early with a champagne brunch a not-champagne beverage that was vaguely strawberry-flavored. That would illuminate my GI tract. They also injected contrast into my veins to illuminate the rest of me. Soon I will glow in the dark all by myself.

Not-champagne

Afterwards, I was instructed to drink lots of fluids for the rest of the day to flush the contrast from my system. It was such a beautiful day that I started with coffee and walked to the top of a small volcano.

Coffee on top of Mt. Tabor, a once-active volcano Once I got home, I didn’t have a lot of time before I headed to the cancer center. Since radiation is over,  I just go right to the 11th floor. An assistant calls my name and escorts me to one of three huge infusion “pods.” Today I had Pod C, with massive windows facing two different directions. Just beautiful. The visit always starts with The Taking of The Blood. Then JC, Dr. Oncology’s medical assistant, fetches me and brings me to an exam room, generally #47. I ask her if she’s gotten her bicycle yet– she doesn’t know how to ride one, but promises she will learn– and she tells me to uncross my ankles so she can check my blood pressure. Then she tells me about how she went camping last weekend and was so glad it didn’t rain. I set up my iPad for the family to Zoom in. Dr. Oncology comes in just as we are admiring Ruth’s adorable new haircut– her first at a salon since the start of the pandemic. Her partner has been doing a great job, but now that they’re fully vaccinated, she wanted to get back to normal. Dr. Oncology adds to the compliments, although I don’t think she really looked. She’s an odd one, that Dr. Oncology. Answers all our questions without tolerating stupid ones. (She must have taught high school at some point in her life– when people say, “There are no stupid questions,” I always want to say, “Well, you’ve obviously never taught high school.”) So I try not to sound stupid, but since I know very little about all this stuff, I fail before I open my mouth. What I did learn today is that all the lab reports give all information related to the numerical & other results, and all the information doesn’t necessarily apply to every patient. (I still liked learning what it means that “the tumor is microsatellite stable.”)

Today’s results: Tumors are smaller, with “adjacent scarring/architectural distortion,” meaning they are fried and probably dead. Ha! Also, the blood results are good, and we’ll go ahead with the Durvalumab infusion.
After, I got more paper about side effects and a bag of jungle cookies to take home with me. I go back in two weeks for more. They want to fire up the immune system to hunt down any teensy remnants of cancer cells and destroy them. Sometimes the immune system gets too fired up– that’s the source of side effects. If things get too intense, they can give you massive doses of steroids to cool things dawn. Then they may try the Durvalumab again. You just have to see– “a judgement call,” Dr. Oncology said.

I especially liked one exchange we had. I told her that I reviewed the five-year survival statistics and rejected them as being prescriptive or predictive for me. “Good!” she said. She told me she liked the statement, “I accept the diagnosis, but not the prognosis.” Yep. I like it too.
Thanks for reading.

Image by Garik Barseghyan from Pixabay