Visit to Oncologist continued

We visited the oncologist… actually two oncologists on Monday. They reviewed the biopsy and CT results, gave us general Lymphoma info, talked to us about where my Lymphoma fits in, and told us what the plan was going forward. All in all, they were pretty awesome visits with two remarkable doctors. Eric and I listened diligently, took copious notes, chose which of the two doctors we were going to move forward with, and started making future appointments. One hell of a busy, stressful, relatively good day.

The CT Results Report was fun (relatively) to look at. It talked about the supraclavicular, axillary, and pectoral lymph nodes where I believe the majority of my enlarged lymph nodes are; basically this means that they are on the right side of my body above my diaphragm. There were a few small ones in my mediastinal which is behind my breast bone. If the PET doesn't uncover more cancer, these swollen lymph node locations put me in stage 2.

Like I said, it was relatively fun to read the report, but Eric and I did take issue with part of it. The report said I had a “grossly unremarkable spleen.” We were sure that my spleen would resent that comment … even if we don't know where my spleen was.

We talked about the Lymphoma info next and where I fit in. The Doctor actually told me that I was most likely in stage 2a. I was happy to hear him say it since I have been diagnosing myself as 2a for several days now. He also said that staging isn’t as important as “favorable” v. “unfavorable” Lymphoma. There are several factors that put a person into the “favorable” category. The verdict is still out on my category, but so far so good. One of the tests for favorability was the CT scan. In order to test favorable I needed all my nodes to be within 10cm. My largest is 6cm (originally I thought it was 7). We should know more on my category after the upcoming tests.

The plan is to start chemo on December 29th; most likely I will be doing it for 6 months. They will however reevaluate 2 months into the therapy by doing another PET scan. If all of the cancer has disappeared by then, we may skip radiation altogether and/or shorten the chemo by a couple months (though not many patients have chemo for less than 6 months). If the list of tests below continues to put me in the Stage 2a “favorable” category which I am currently in, then I could have a cure rate as high as 95% with the treatment (meaning after the initial treatment, 95% of patients do not have a reoccurence). If I respond well to chemo and we can avoid radiation, then I don’t have the additional risk of secondary cancers 10-30 years down the road. So, that’s really good news!

Here’s my list of tests between now and the start of chemo.

• Pulmonary Function Test - it’s a group of tests that measures the air intake and release in my lungs – one of the medications in my chemo regimen can cause lung damage


• PET scan - it can distinguish scar tissue from malignancy where the CT can’t – keep your fingers crossed that they don’t find additional cancer in an organ – they don’t think so, but it’s possible


• bone marrow biopsy - not looking forward to that one – there’s only a 1% chance that It’s in the marrow, but a positive test in the marrow will give me a ticket to stage IV.


• MUGA test - “highlights” red blood cells and watches my heart to see how many blood cells it pumps at one time - it’s determining how well my heart is functioning. Some radiation which I may not have, can affect your heart.


• Sedimentation Rate - we want this to be low to be favorable. It’s the rate that “extra” proteins in the blood bind to the red blood cells and make them “fall out” of suspension in the blood plasma – or something like that. Makes me wish I paid closer attention in Biology.
  

Then we’ve got the Pneumonia/Flu shots, the follow-up with the surgeon, and another meeting with my wonderful (and experienced) General Practicioner.

Like I said, all in all it was a good day.