Cancer Scan Anxiety <sigh>
“Twitchy.” That’s how Dr. Oncology describes the way a lot of her patients feel about a cancer scan during the holiday season. “You just feel twitchy.” She wriggles her shoulders to demonstrate this emotional state. It’s oddly effective; that’s exactly how I’ve been feeling: weirdly anxious, in a low-level squirmy kind of way.
The past month has been a strain. One friend’s disease has progressed. Another friend copes with difficult side effects from a clinical trial. People in one of my online lung cancer groups are struggling. It’s as if these things, along with my own nerves, compounded into a deep ache of fear that made itself known about two weeks before my December scan. I made dark jokes to whomever I thought could handle it and shared honestly when people asked how I was doing. And I waited.
The scan was last week. The report came in about two and a half hours after I got home. The bottom line:
Stable examination with post treatment changes in the right lung with stable moderate scarring in the right lower and middle lobes. No evidence of focal tumor recurrence. No metastatic disease.
Start the party, right? I had a moment of huge relief. The thought I’m free for three months! was quickly followed by the blinding awareness that I have a chance every day — please hold one moment for the department of cliches — to live intentionally.
Now, that is a sobering thought, because left to my own (slovenly) devices, I might lie on the couch and read princess novels –hey, no judgements about slovenly reading selections, OK? Instead, all my thinking about gratitude and mindfulness has wormed its way into a new compartment in my head so I spontaneously think things like live intentionally — and I mean them. Have I brainwashed myself? Maybe. But, as a friend used to say, maybe your brain needed washing.
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Two things of note
Thing 1
The report included a comment that there was moderate volume loss in the right lung’s middle lobe (due to post-treatment scarring.) I remember Dr. Radiology saying that after radiation treatment to the lung, even an award-winning athlete would never see their best times again. It’s not what I want to remember, hear, or read but it sure explains why there was little improvement in the fitness test I recently completely.
This test is so gnarly that people routinely do what they can to avoid it. (By people, I mean us dedicated recreational athletes.) But I did the test twice, because the first result showed a loss in the power I could generate. Given the way I’d been riding, I knew that result was ridiculous. Afterwards, with a little thought, I realized what the score really showed was that, prior to the test, I’d been chatting outside with a neighbor as a chilly wind came on. (My lungs seize up in chilly air.) I knew something was off as I started that test. Did I listen to that and stop? Uh-huh. Sure. <cue eye roll here.>
Anyway, I ditched that imposter score and retested a week later, with a net result of an increase of — drumroll please– one point. That’s oddly OK, because segments of the test where I’ve previously bottomed out show growing strength. I’ve concluded it’s going to take a lot of training to see improvement from here on in.
And, truth be told, it may be that this is as good as it’s going to get. We’ll see at the end of the next 6 months.
Why does this matter so much? Because I love riding my bike. And ‘cuz me & the hubs are going on a bike trip along the Danube in early June and the first day includes an elevation gain of 2,300 feet. So, #training! More about this to come.
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Thing 2
We all cope with anxiety differently. Information soothes mine, so I went in to my appointment with a strategy to get some. I asked Dr. O about her thinking on treatment after resistance develops to the TKI (targeted therapy) I’m on. She was about to start in with some soothing thing like “now, now, that’s not going to happen” (yes, I’d like my toxic positivity with a side order of sparkly rainbows, please) when I shook my head and said, “C’mon, we both know that’s down the road, maybe in 5 years, maybe in 5 months. But that’s what happens.”
I clarified that my interest was purely hypothetical, which it actually was. What mattered to me was 1) whether she’d engage in conversation about it at all; and 2) her approach.
To her credit, she responded briskly. First, there would be a biopsy to see if the cancer had transformed (from non-small cell cancer to small cell cancer, which is very bad), or developed new mutations. Then there would be treatment. As I suspected, one option could be a recently approved drug (a bispecific antibody) that’s well tolerated and given with chemo. (Here’s the article she referenced.)
Would my history of pneumonitis affect these or other treatment options? (This has really been a worry for me.) She said she didn’t think so. OK, then. (Truth be told, I think pneumonitis is always a concern with lung cancer patients, but today I’m choosing to be comforted.)
We also kicked around the idea of double-dosing the TKI. She said that was mostly given in the event of leptomeningeal disease. And other things, I thought, but I kept my mouth shut. I’d gotten what I came for; there was no need to push further.
So, there you have it. The scan before Christmas turns out to be the harbinger of a happy holiday.
Thanks for reading. Here’s hoping that if you celebrate the season, you have a humdinger of a time.
P.S. How could I forget cakes? Here are two of the latest.
