Thursday, November 4, 2021
I got to see Dr. Radiology today, which included my favorite activity: looking at all the CT scans of my lung cancer side by side and comparing the changes over time. SO. COOL.
I love that she never rushes, that she asks multiple times if there are any other questions, that she always includes my Zoom team in her comments.
Today, I loved the news she delivered, but what I loved is probably not what you’d expect.
Fitness & #$%^ steroids: I can increase the intensity of my workouts! Steroid use can cause muscle degeneration in the shoulders and hip girdle (not sure of the term she used). That’s probably why my shoulders hurt when I’m doing planks. But the stationary bicycle is likely taking care of the hip area. Plus, do squats. I will need to focus on this after I’m off the steroids. Not only can I do this, but I love doing it!
However, she said I should not worry about losing weight until the steroid level is much, much lower– “It’s just going to frustrate you,” she said. Well, that explains a lot. She also felt I could up the intensity of my workouts slowly. I cannot tell you how much this means to me. Once I’m fully off these dang steroids, I’m going on a for-real bike ride outside, no matter the temperature or the weather. I can’t, however, stop taking the Very Fancy Antibiotic (more than $700, before insurance; $200 after; sheesh) until, you guessed it, the steroids are gone.
CT scans show a continuing decline in the size and shape of lymph nodes. At the start, one of them was apparently quite large– I’m glad I didn’t fully grasp the reality of that before treatment began. The big tumor is flat and dead. Basically, Dr. Radiology doesn’t think there’s any cancer left. She anticipates there will be some scarring from the pneumonitis, but given that I’m not experiencing difficulties with breathing or pain, she thinks I am likely to sidestep the common progression of pneumonitis to full-on pulmonary fibrosis.
Evidently, the mile markers after treatment ends are six months and two years. Reaching the six-month mark with no recurrence is a Very Big Deal. The two-year mark is similarly Big. Recurrence after that drops to a 15% chance. I had no idea that six months was some kind of magic number. No wonder all the doc offices were calling. And here I thought they just missed me.
New Methods: There’s no way to tell if any cancer cells have escaped and are floating around. New detection technologies– liquid biopsies— are on the horizon to routinely track the presence of cancer cells in regular physical exams, for up to 50 different kinds of cancer. This 2020 article reports that the FDA approved two blood tests to identify treatment pathways for certain kinds of NSCLC (non-small cell lung cancer). Compare that to an earlier article about liquid biopsy, from 2017. You can see the progression in the research that took place over only three years. What’s the big deal about liquid biopsies? Detection happens through analysis of a simple blood draw, which is simple and faster than the typical biopsy and analysis, which can take weeks. But for now, what my docs can do is monitor via scans. That’s OK. I’m still hoping I can achieve my goal of spontaneously glowing in the dark.
Covid: As long as I’m on steroids, I have to be very, very cautious about being involved in the world. Dr. Radiology, too, has season tickets to soccer– the Timbers, Portland’s men’s soccer team– and, like me, has not attended games, mostly out of fear that she could unknowingly spread Covid to a patient in the clinic. <Sigh> I’ll return to life soon enough, I guess.
Pulmonary Embolism: In scans Dr. Radiology has done on patients in the last four to six months, she has noticed the occurrence of atypical, i.e., with no symptoms, pulmonary embolisms. Usually, there’s swelling in the leg, sometimes with pain, and pain in the chest. The ones she’s observed have exhibited no symptoms. Rather, the PEs were discovered on CT scans done for reasons other than to check for PEs. These PEs are also not complete blockages. She is wondering if this isn’t related somehow to Covid, either the vaccine or exposure to the virus itself. This is all anecdotal, she emphasized, but she finds it really interesting. Me too.
Recurrence: I also checked my understanding of the things that would happen were there to be a recurrence. I had it pretty much down. There’s no point getting into it unless I need to. I’m pretty much done with tracking research and thinking about stupid cancer.
It was funny to observe my reactions as I listened to her. I actually heard myself think, I don’t give a rat’s ass about cancer– I only care about being physically active again.
Plus, cake decorating. If I’m not going to work or be running around in the world until I’m stronger, I’d better do stuff I like. So, yesterday, I signed up for a multi-week class in cake decorating. It starts at the end of January; by the end of seven weeks, I will be able to make and decorate a wedding cake. Take that, stupid steroids. Take that, stupid cancer. NO CAKE FOR YOU!
Here’s hoping your day includes a little cake, or at least a cookie or two.
Thanks for reading.
Images
-
- New Adventure by Alexas_Fotos
- Bike Image by Gordon Johnson from Pixabay
- Missing Image by kropekk_pl from Pixabay
- Coronavirus Image by Gordon Johnson from Pixabay
- Rodent Image by Prawny from Pixabay
- Cake Image by Vanessa SG from Pixabay