New Stages in Lung Cancer? Not Today | Dec 12 2021

It’s been a wild couple of days. I wrote sections I & II to think/talk about surveillance scans (Tuesday) and my meeting with Dr. Oncology (Wednesday). That was before my meeting with Dr. Radiology (Thursday) when everything changed. I thought I’d throw out sections I & II, then I realized if I wanted to convey, even in a small way, the experience I had, I should just take you through what happened.  Here it goes….

December 14-16, 2021

I.

I had my 3-month surveillance scan early Tuesday morning, 12/14.  I was in and and out, going from the CT right to an ultrasound of the thyroid gland they’ve been tracking for 4+ years now.  (The Experts should figure out a way for experienced test-takers to do these like drive-through Covid tests.)

The system delivers your results to your digital chart as soon as they’re available.  I had the CT at 8:30 a.m. and the results in my hot little hands by 11:30. Here are the highlights:

Number 3: good (that’s the pneumonitis)

Number 2: good.

Number 1: you caught that M word, right?

We were seeing Dr. Oncology the next day, so I went right to work to prepare.

I checked the National Comprehensive Cancer Network‘s recommended treatment practices for Non-Small Cell Lung Cancer. (They have these for 60 cancers!) It’s a very cool chart you can click through to see the treatment pathways based on symptoms, test results, etc.

Then I reviewed my reading about treatments that target my particular genetic mutations.

Then Mark & I looked at questions we wanted to ask Dr. Oncology and I predicted what would happen next (no, not because of a cancer crystal ball, but because of my reading.)

Then I went into a couple of lung cancer communities I’ve recently joined, shared the CT scan news and our questions for Dr. Oncology, and asked for their thoughts.

Then I got mad at M, because it appears I want to make everyone suffer for loving me. Or maybe he really was being the way I thought he was and thus deserved to be in the doghouse. (You can imagine what he would say.) But the benefit of some 30+ years of marriage (don’t make me do math this late at night) is that we’ve learned to smooth out things like this, which we did. Despite feeling somber, we both slept well, and we backed out of the driveway Wednesday morning braced for what was coming.

II.

According to the CT report, I appear to be growing very, very small new nodules in my right lung– kind of like little trees in fertile soil. Too bad for me that they’re growing nowhere near where the original treatment area was. Dr. Oncology says she thinks this means there were still teeny tiny cancer cells floating around; because they’ve now planted themselves far from the original tumor mothership, it’s not a recurrence as much as it is a progression. Welcome to Stage IV.

Do you remember? All along, I’ve been saying that lung cancer is very sneaky and rarely goes away completely.

So. PET scan and MRI on January 3. PET scan will show any new areas in the body where the cancer may have traveled. (The sugary solution I drink will be taken up by the most active cells, which will glow green, indicating badness.) The PET can’t reach the brain, though, hence the MRI.

I think I’m OK. There were the minutes walking to the car in the cancer center parking garage where I wept. (But since I still barely believe I have lung cancer, how long can weeping last?)

I told Dr. Oncology that I know several people with immune disorders who have also enjoyed (not) a long-term relationship with prednisone. “We all agree,” I told her, “it’s ridiculous that the people who make bags of granola don’t list the calorie count for the entire bag.”

She guffawed.

Thursday, I see the Queen of Cancer Radiology. We’ll see what she says.

One more thing. It strikes me that the work I’ve been doing on the cope/hope front is standing me in good stead. My thought this morning was, yes, there’s a lot of new crud, and yes, I’m kind of reeling. And, more important, I get to make a choice, every day. Where do I want to dwell? Amidst what beliefs? What kind of future? What am I willing to roll up my sleeves and work toward?

Where do I want to dwell?

III.

There is a reason I worship at the court of the Queen of Radiology.

She started with, “I talked to Dr. Oncology yesterday. I told her I am not persuaded these nodules are cancer.” Her reasons?

1. The nodule that was first spotted on the scans in September wasn’t solid; it is now smaller to the point of being invisible.
2. The new sprouts aren’t near the tumor mothership, but they are in the area that’s been inflamed for months. That poor right lung is just so…messy (her term). While there has been a great deal of inflammation in the lung (no kidding, says the Queen of Prednisone), you can see that the inflammation is dissipating. The sprouts are in the the mess– were they just invisible because they were hiding behind the  inflammation and now that the inflammation is healing they are visible? Who knows.
3. She ushered me through many different views of the new spots. They are really tiny. (And, we could see the tumor– it’s like a big scar. Dead! )
4. I feel fine. My breathing is fine. I’m working out for increasingly longer periods of time and will soon start to increase the intensity. I’m not coughing. Wouldn’t there be some overall indication that something has changed? She said that often there’s a holistic change, sometimes there’s not. But she was interested to hear my observation as just one more piece of data.

She thinks Dr. Oncology’s plan to scan, see what’s up is the right thing, then talk about re-staging. She’s not sure if the nodules will even be big enough to light up with the PET scan, but at least we’ll see if other areas of the body light up. And we’ll get a view of the brain, too. She thinks the best thing will be to bring the scan results to the tumor board and have lots of sets of eyes on the case in order to come up with consensus on the next steps. (I would love to be a fly on the wall for one of those meetings– I got the impression there can be a lot of heated discussions…?)

So. the PET and MRI are on a Monday, I see Dr. Oncology on a Tuesday, and the tumor board meets the following Monday. Dr. Radiology doesn’t always call in to those meetings, but she will try very hard to do it for this meeting. I can call her any time to discuss the findings and plan.

Do you see why I think she is the Queen?

For now, the roller coaster has glided to a stop. And that’s a good thing.

Here’s hoping there aren’t too many dips and curves in your day.

Thanks for reading.

Credits

Blue Rollercoaster by nitli from Pixabay

Growing green things by Jo Re from Pixabay

Sunbeams by jplenio from Pixabay

Crown by Prawny from Pixabay

Black & White Rollercoaster by Gordon Johnson from Pixabay