Monday, November 16, 2009

Tuesday, November 17th, 2009 -- Scan/Test Results

Hi all... as I mentioned on Facebook, I would come and put a blog entry up to explain my CAT scan and blood test results here in more detail. Of course, I did say I would do it when I got home from the auditions for Fighting Chance Productions "The Wedding Singer", but that turned into us stopping at Maxine's, then getting home shortly after 11pm and taking Bridget out between downpours. So, here I am, just after midnight and am going to attempt to explain here.

The Scan/Blood tests were a good news/sobering news kind of result. My oncologist eased my fears by starting with "Not to worry... the results are good news, but I will explain what that really means". A double edged sword!!

For starters... the good news is there are no "new" growths on my lungs. When cancer has metastacized (IE: has spread from the original organ to another, or other organs) it means that it is now "systemic" and once it lands and takes root in an organ, then the expectation is that it will multiply in growths. So, the fact it had spread to my adrenal gland, it couldn't multiply there because we took that gland completely out. But then it also had spread to my lungs, and there were "multiple" growths (12 to be exact) sprinkled throughout both lungs. The largest growth/tumour, we had ablated back last Feb., which left 11 smallish "nodules" or growths/tumours. The expectation is that once colon cancer spreads to the lungs, then it will grow rapidly. One treats this with chemo... in the hopes that the chemo will slow down the speed of the growth, as well as the number of growths.

But I am an enigma ;) The speed of growth in my lungs is "excruciatingly slow"... to the point, my oncologist and her team have never seen such slow growth in a colon cancer spread.

Since last March, there has been no new growth/nodules at all. And with the nodules that are there, two of them have grown about 2mm (about .07 inch) since July. That, apparently is incredibly slow... and she says that there is no need for us to even attempt treatment since the treatment would be chemo and the whole purpose of the chemo would be to try and slow down the growth. But there is no way chemo is going to slow it down to any slower than it currently is because it is so slow now.

So then there was the blood test which measures the CEA level in my blood. CEA is just a measurement of metabolic activity... it doesn't pinpoint where there might be cancer, but if there is active cancer in the body, then the CEA (in some patients) will rise, which indicates there is active cancer somewhere in the body. Any reading under a 4.0 is considered normal, inactive activity. In July, my CEA reading was 1.6... a decent reading quite below the "normal" active reading. Now, in November, my CEA reading is 2.2 ... a slight rise of .6. This is not concerning my oncologist because it is still well below the norm of 4.0 ... but it is going to be worth monitoring.

Sooooo... I am absorbing this information. It usually takes me a day or two to absorb, compartmentalize, and arrange it so I can go back into denial :) When I was labeled as being "stable" back in July, I absorbed this info, compartmentalized it and managed in my mind to relate "stable" with "benign" or "no longer active", which of course isn't quite true. So now, here I am where I'm still considered somewhat "stable" with a small amount of growth on a couple of nodules... which of course has surprised me because I had talked myself into being inactive/benign ;)

So what's the plan?? Well, it's actually good... Sharlene is going to schedule my next scan for 6 months from now! SIX MONTHS!! That's incredibly good news because it is very rare for a Stage IV cancer patient to be decreasing their scans rather than increasing them.... but she's going to schedule a CEA blood test 3 months from now to see whether the reading goes up or falls back down to the 1.6 range. IF the CEA goes up, then she will bump the CAT scan back up to the four month (which I was expecting two more at 4 month intervals). If the CEA remains the same or less, then we'll keep the CAT scan at 6 months.

So as you can see, there isn't any need to panic, or be too worried since the growth is so slow, but it is still something that we have to monitor. She says that at some point they will get large enough that we will want to treat them, whether we ablate them if there's only one or two larger ones, or if they all start growing, then we treat them with chemo. The purpose of the chemo would be to shrink them and slow down the growth... but she would just as soon leave chemo to a last resource and not put me through it unless she feels there would be some benefit. I agree.

Meanwhile, she is going on a six month sebatical (besides being a clinical oncologist, she also is a researcher). But she said that, although she won't be at the oncology office and seeing her patients, she will keep in touch with me. When I have the blood work done in 3 months, I'm to send her an email... she will then look up the results and we'll either talk on the phone or in email. As for the CAT Scan... if we keep it at 6 months, then she will be back for the results from that one... but if the CEA test indicates I should have an earlier CAT scan, then she will re-arrange it and have one of her colleagues see me to go over the results of the CAT scan. In other words, just because she will be on a 6 month sebatical, I won't be losing my oncologist :)

Sooooo, onwards I go. It certainly is an enigma that my cancer is not acting like it's suppose to... on the other hand, thank goodness it's not :)