The Tumor Board's Recommendations

I got a call a while ago from Dr. Weickhardt with the results of the tumor board's review of my CT scans. As I wrote earlier, one area in the latest scan had grown significantly over a six-weeks period while other areas remained stable. The tumor board found that it was unclear from the images whether the area was a collection of fluid or tissue. Consequently, they recommended using a needle under radiological guidance to aspirate the fluid or tissue in order to determine its nature. I was very please with this recommendation because I have a hard time thinking that the area is a tumor because it will settle the question.

I will continue with my pemetrexed chemo on Wednesday, and when my blood counts have returned to normal they will do the aspiration. My money is on the results showing a fluid concentration because the area shrank and then expanded and did not light up the PET scan, but we'll have to wait and see.

David

Chemo Postponed

My next round of chemo has been postponed until next Wednesday.  It was scheduled for today, but the oncologists want to wait until the Tumor Board revoew my PET and CT scans on Monday.  The PET/CT from last Monday found one area that appears to have grown in the last three weeks.  The oncologist showed me the last five or so scans, and the area of interest is associated with the pericardium (the sack around the heart).  Between August and about December the area seemed to shrink.  Then it was essentially stable until this last scan.  It may be an area of fluid collection rather than a tumor, but it is hard to tell.  The Tumor Board is a meeting of the oncology staff in which cases are reviewed.  Multiple radiologists will be there to look at the scans and discuss what they see.  Dr. Weickhardt will call me on Monday to let me know what they think.  I have my next chemo scheduled for Wednesday, but the decision of what to do will be made on Monday.  If it appears that the area is not a tumor, then we will proceed with the current chemo.  If it is growing, then we will go with a new drug, or we might decide to take a pause and think it over.  One other puzzling factor.  The area did not light up on the PET scan which identifies areas glucose uptake like the brain or cancer cells.  That gives me hope that the area is a collection of fluid.  I don't know what that would imply or if it would be significant, but it seems to make the most sense to me--the only area to grow and no glucose uptake.

I'll write a post with the decision next week.

On the family front, we had a great visit from our daughter, Sarah, and her son, Jamie.  It was good to have both girls and their families (but unfortunately without Ryan) here together.  The noise and chatter was like a visit to the grandparents at Thanksgiving or Christmas.

David