Bad news

Yesterday I saw Dr G and got the results of Tuesday's brain MRI and labs. The MRI suggested progression in the central nervous system, meaning I have new, and growing, brain mets. My labs were significantly higher than eight weeks ago, with tumor marker CA 27.29 at 214 and CEA at 40. (Both had been at or near normal.) Clearly this clinical trial is inadequate to treat my cancer.

Dr G and I discussed several chemotherapy drugs that cross the blood-brain barrier or which have a track record for treatment of brain metastases. We also discussed further radiation therapy. Gamma knife may be an option again. Whole brain radiation (WBR) is not an option, as it might likely cause dementia. (My radiation oncologist agrees.)

Although I took the final FDG PET scan of the trial on Monday, no results were available in my electronic record at SCCA. Having any more information might have helped in yesterday's difficult conversation with Dr G. It looks like I will have to wait until after the FES PET scan next week to get information from Dr Gadi. Then I'll see Dr G again to make a plan.

This news was like receiving punch in the stomach. Last year, my complaints of "feeling stupid" led to Dr G ordering a brain MRI. This time I have no symptoms. Indeed, I feel great on the trial regimen. But it's so not working.

I hate the waiting game, when I don't have all the information, just enough to scare the daylights out of me. I was a little taken aback when Dr G asked me directly what Iw anted to do. I think this was "doctor-speak" for was I ready to stop all treatment.

I'm not ready to stop treatment yet, but neither am I interested in treatment which will impair my quality of life drastically. (Hence no WBR, or chemo which would increase my neuropathy.)

Dr G made an analogy to the Battle of the Bulge, which was the last major Nazi offensive against the Allies in World War Two. I could now be facing my last effort to pound my cancer down into submission. 

I hate these battle images, but I did have a talk with my cancer last night. I told my cancer that if it gained so much ground, it would lose the ultimate battle. If it kills me, then it dies too. 

Years ago, not long after my mets diagnosis, I told my cancer that as long as it behaved, it could have a place in my body. The moment it acted up, I would hit it with everything at my disposal. Well, my cancer has been more or less quiet for almost a decade. I am prepared to hit it hard now, but still give it living space, if it will make the deal.

Scans, scans, scans

This week I am in the third and final round of scans for the clinical trial at SCCA.

Yesterday I had to FDG PET scan, the one done fasting. Rik is off school this week, and he took me to SCCA at just past the crack of dawn. I hadn't slept well, so relaxing in the chair while waiting for the radioactive dye to uptake was no problem. I am sure I slept because I woke myself with snores on several occasions. Same with the scan itself.

Afterwards we tried a new place for blunch. (Blunch is what Rik's mother calls the meal between breakfast and lunch. Brunch is more of a late breakfast.) We went to Brave Horse Tavern, where our server was a former student of Rik's. Now, of course, instead of being a short 8th grader, he was a tall young man sporting a mustache. I dined on hearth roasted asparagus with melty teleme cheese, grated egg, and green garlic bread crumbs and shared some good fries with Rik, who had a burger.

By the time we got hime I was ready to crash, and we both napped for more than an hour before attending a volunteer training for theatre ushers.

Today I have a brain MRI as part of the follow up to the brain metastases discovered last spring. This is at Dr G's office, where they will also draw blood to test my tumor markers.

On Thursday I see Dr G, who will give me the results of the brain MRI, the labs, and hopefully the FDG PET scan (assuming SCCA gets him the report in time. I asked for them to fax it but you never know...).

In the middle of all this I'm also going to the dentist for a regular check up. It's a week of doctors, even more so than usual.

The final FES PET scan is next Monday, and I see Dr Gadi next Wednesday for the final, final report on if I am eligible to continue with the trial protocol.