Tonight, I got a message from an old friend, Karen Banks, reminding me that I had not posted the results of my end-of-March chest biopsy. The PET and CT scans at the time had shown an area that seemed to be growing while other sites remained stable. The Tumor Board recommended a biopsy of the site because they could not tell whether it was tissue or fluid. Luckily, it turned out to be fluid with no significant characteristics, and on April 3 I got my sixth pemetrexed infusion of this second round of chemo. This week I went in for the seventh round on Tuesday, so I am a little under the weather right now. I'll have another CT scan on May 14, and at my pre-infusion appointment with my oncologist on Tuesday, I asked what he thought about my taking a two month hiatus if the CT results show that the cancer is stable. This kind of chemo is not particularly debilitating, but it would be good to have a break and regain my strength and health a little. The steroid (dexamethasone) that I take at the time of my chemo and my lack of exercise and my poor diet have raised my blood sugar to unacceptable levels, so a break would also help me get it under control again. He thought it would be a good idea, so I'm looking forward to the CT results in May.
Nothing new on Jana's CML. Everything is under control, and she has been busy working in the yard and making things with her sewing/embroidery machine.
On a personal note, we are looking forward to going down to Big Bend National Park for a few days with our friends Tim and Susan Kilkenny. Jana and the Kilkennys will probably be focusing on what birds and wildlife they can see, and I will be more interested in taking pictures of the place. I just ordered a digital 3D camera and look forward to exploring what it can do.
Thank you for following our blog.
David
April 26, 2012
April 4, 2012
Some Encouraging News
When I was diagnosed with mesothelioma, the initial surgical options were to have a pleurectomy/decoritication (P/D) in which the lining of the lung and the chest cavity and any observable tumor tissue are removed or an extrapleural pneumonectomy (EPP) in which the lung is removed as well. I was scheduled to receive the EPP, but when mesothelioma was found in the sack around the heart (the pericardium) the procedure was changed to the P/D.
I receive email postings from a site called OncologySTAT, and today I read the abstract of a study that found that the E/D was superior to the EPP. For example, the two-year survival rate for the P/D was 49% versus 18.2% for the EPP. The respective five-year survival rates were 30.1% and 9.1%. My conclusion is that the extra risk associated with the lung removal outweighed the more complete removal of the tumor tissue. When I last saw my surgeon, just before moving to Denver, he seemed surprised at how well I looked and noted that perhaps it was best that he could not do the EPP. Now it looks like he was right.
I am encouraged to see the survival rates because they are greater than I expected from what I had seen previously. The results give me hope that I will live long enough to have real conversations with my grandchildren and to do things with them that they will carry in their memory into adulthood.
On another topic, no significant news from my appointment with my oncologist yesterday. It will be a week or so before the pathology report on the fluid removed from my lung will be ready. It will tell us how many cancer cells were present in the specimen and perhaps provide a better understanding of the cause of the fluid collection. I had an uneventful infusion following the doctor’s appointment and will have one more round in three weeks before my next CT.
Here’s the link to the abstract: http://www.oncologystat.com/journals/journal_scans/PleurectomyDecortication_is_Superior_to_Extrapleural_Pneumonectomy_in_the_Multimodality_Management_of_Patients_with_Malignant_Pleural_Mesothelioma.html
David
I receive email postings from a site called OncologySTAT, and today I read the abstract of a study that found that the E/D was superior to the EPP. For example, the two-year survival rate for the P/D was 49% versus 18.2% for the EPP. The respective five-year survival rates were 30.1% and 9.1%. My conclusion is that the extra risk associated with the lung removal outweighed the more complete removal of the tumor tissue. When I last saw my surgeon, just before moving to Denver, he seemed surprised at how well I looked and noted that perhaps it was best that he could not do the EPP. Now it looks like he was right.
I am encouraged to see the survival rates because they are greater than I expected from what I had seen previously. The results give me hope that I will live long enough to have real conversations with my grandchildren and to do things with them that they will carry in their memory into adulthood.
On another topic, no significant news from my appointment with my oncologist yesterday. It will be a week or so before the pathology report on the fluid removed from my lung will be ready. It will tell us how many cancer cells were present in the specimen and perhaps provide a better understanding of the cause of the fluid collection. I had an uneventful infusion following the doctor’s appointment and will have one more round in three weeks before my next CT.
Here’s the link to the abstract: http://www.oncologystat.com/journals/journal_scans/PleurectomyDecortication_is_Superior_to_Extrapleural_Pneumonectomy_in_the_Multimodality_Management_of_Patients_with_Malignant_Pleural_Mesothelioma.html
David
April 2, 2012
Chest Biopsy Results
Readers may remember that recently a suspicious area in a CT scan had grown significantly over a six weeks period while other areas remained stable. My case was presented to the Tumor Board, and it was determined that the CT’s were indeterminate, so they recommended a biopsy of the area to determine whether it was fluid or tissue.
I had the biopsy today, and it was another interesting experience. I was happy that they needed me to be awake and able to respond to their orders, because I wouldn’t have learned anything had I been unconscious. Here’s what happened. After being dressed in a gown and placed in bed, I was wheeled over to the radiology department where I was placed in the CT machine. If you’ve ever had a CT scan, then you know that you are placed on a narrow bed and moved feet first into a machine that looks something like a giant doughnut. The doctors took a preliminary scan and studied it to plan how to get the needle through the overlying tissue. There were three areas of risk. First because they were going to have to go through the lung, there was the risk of a lung collapse because of air leaking from the puncture site. There was also a risk of bleeding, and finally a risk of infection. The doctor who visited with me prior to the procedure said they might not be able to find a safe path to the target because of the location of the target area (near the middle of the chest and near the major blood vessels at the top of the heart) and might have to cancel the procedure.
They found a path and began by giving me a local anesthetic at a couple of locations on my chest. That was the only painful part of the procedure, and it was really just a pin prick. Then the doctor began the procedure. I was not able to observe much visually because they took away my glasses, but I could tell what the doctor was doing. He would insert the needle, then take quick CT scan to see where it had gone. Then the two doctors would say a few words about what to do next, and repeat the process.
After a few minutes they reached the target and withdrew a sample—a fluid not tissue. I was pleased to hear the news! I do not know how much better it is to find a fluid, but in my ignorance, I’ll take fluid over tissue. The fluid was slightly darker than what I would call “straw colored,” and I was glad to see that it was clear. That’s got to be better than cloudy. I’ll see my oncologist tomorrow and find out more where the liquid might have come from and it’s significance. It will be about a week before the complete results come back from the pathologists.
After the procedure, they gave me a chest x-ray that showed no complications and took me back to recovery where I was to wait for four hours. After a couple of hours I had another chest X-ray that also showed no complications, so they cancelled the third X-ray and let me go an hour early. Unfortunately, the nurse failed to call Jana to come get me, so I sat in the waiting area for the third hour anyway.
All in all, it was a successful day.
David
I had the biopsy today, and it was another interesting experience. I was happy that they needed me to be awake and able to respond to their orders, because I wouldn’t have learned anything had I been unconscious. Here’s what happened. After being dressed in a gown and placed in bed, I was wheeled over to the radiology department where I was placed in the CT machine. If you’ve ever had a CT scan, then you know that you are placed on a narrow bed and moved feet first into a machine that looks something like a giant doughnut. The doctors took a preliminary scan and studied it to plan how to get the needle through the overlying tissue. There were three areas of risk. First because they were going to have to go through the lung, there was the risk of a lung collapse because of air leaking from the puncture site. There was also a risk of bleeding, and finally a risk of infection. The doctor who visited with me prior to the procedure said they might not be able to find a safe path to the target because of the location of the target area (near the middle of the chest and near the major blood vessels at the top of the heart) and might have to cancel the procedure.
They found a path and began by giving me a local anesthetic at a couple of locations on my chest. That was the only painful part of the procedure, and it was really just a pin prick. Then the doctor began the procedure. I was not able to observe much visually because they took away my glasses, but I could tell what the doctor was doing. He would insert the needle, then take quick CT scan to see where it had gone. Then the two doctors would say a few words about what to do next, and repeat the process.
After a few minutes they reached the target and withdrew a sample—a fluid not tissue. I was pleased to hear the news! I do not know how much better it is to find a fluid, but in my ignorance, I’ll take fluid over tissue. The fluid was slightly darker than what I would call “straw colored,” and I was glad to see that it was clear. That’s got to be better than cloudy. I’ll see my oncologist tomorrow and find out more where the liquid might have come from and it’s significance. It will be about a week before the complete results come back from the pathologists.
After the procedure, they gave me a chest x-ray that showed no complications and took me back to recovery where I was to wait for four hours. After a couple of hours I had another chest X-ray that also showed no complications, so they cancelled the third X-ray and let me go an hour early. Unfortunately, the nurse failed to call Jana to come get me, so I sat in the waiting area for the third hour anyway.
All in all, it was a successful day.
David
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