Over the last week our surgeon (Ravikumar) has been reviewing the scans from the 28th July with our oncologist (Moriarty). Today we got a call from Ravikumar's office and spoke to the nurse there.
Essentially he's very happy with the progress and it is significant progress since January. On the down side he recommended 3 more months of chemo followed by a PET scan and another consultation. That will bring us to November.
Whilst it's great news of course that the scans are so good, I can't shake the pit in my stomach at the thoughts of 4 more rounds of chemo with no real knowledge of what lies at the end of it.
We're meeting with Moriarty in person on Friday to discuss in detail and hope to get clarification on what has been discussed. I have a lot of questions. We're going to ask for a 2nd surgical opinion from another doctor we've been researching.
Karen has been a trouper and amazingly strong throughout the day and once again I'm leaning on her instead of the other way around.
Showing posts with label CT Scan. Show all posts
Showing posts with label CT Scan. Show all posts
Wednesday, August 6, 2008
Thursday, July 31, 2008
CT Scan Results - Good News!!!
Karen's doing GREAT and so am I. After an emotional week we finally met with Moriarty this afternoon to review the latest CT Scans (taken this past Monday).
The news is good. Karen's tumors are smaller than they were in April and much smaller than they were in January. The largest tumor is currently 5.5 cm diameter, down from 10cms in Jan 2008.
These tumors were all ablated back in November 2007 and so we are seeing a lot of "calcification" as a result of that procedure. Calcification is exactly what it sounds like, the tumors build up deposits of calcium as a result of being necrotic (dead).
The radiologists' report revealed that the tumors do not "enhance" under contrast. My layman's understanding of this is that the stuff you drink when you're having a CT scan is absorbed by the tumors. This stuff shows up under the scan, making the tumors have higher contrast with surrounding tissue. Karen's didn't do that, therefore they didn't absorb the contrast fluid and hence this is another indication that they might be dead.
How dead they are we don't know. Moriarty said you'll never know they're fully dead but that's ok.
Lastly the scan showed that there is no NEW growth anywhere else. I'd call that a result.
The next step is to get these scans in the hands of our surgeon at LIJ. We burned some CDs and overnighted them this afternoon.
Moriarty and Ravikumar will review and confer this week and we'll have another consultation a week from tomorrow.
The last bit of good news is that Karen's new regime is for Erbitux only. No more CPT-11. Moriarty feels that this is what's having the most effect. The key is to figure out how to keep things where they are and keep improving K's situation. What a great job he and the team have done so far.
It's a lot to absorb, we're both mentally drained. Still taking it a day at a time and for today things couldn't have gone any better.
The news is good. Karen's tumors are smaller than they were in April and much smaller than they were in January. The largest tumor is currently 5.5 cm diameter, down from 10cms in Jan 2008.
These tumors were all ablated back in November 2007 and so we are seeing a lot of "calcification" as a result of that procedure. Calcification is exactly what it sounds like, the tumors build up deposits of calcium as a result of being necrotic (dead).
The radiologists' report revealed that the tumors do not "enhance" under contrast. My layman's understanding of this is that the stuff you drink when you're having a CT scan is absorbed by the tumors. This stuff shows up under the scan, making the tumors have higher contrast with surrounding tissue. Karen's didn't do that, therefore they didn't absorb the contrast fluid and hence this is another indication that they might be dead.
How dead they are we don't know. Moriarty said you'll never know they're fully dead but that's ok.
Lastly the scan showed that there is no NEW growth anywhere else. I'd call that a result.
The next step is to get these scans in the hands of our surgeon at LIJ. We burned some CDs and overnighted them this afternoon.
Moriarty and Ravikumar will review and confer this week and we'll have another consultation a week from tomorrow.
The last bit of good news is that Karen's new regime is for Erbitux only. No more CPT-11. Moriarty feels that this is what's having the most effect. The key is to figure out how to keep things where they are and keep improving K's situation. What a great job he and the team have done so far.
It's a lot to absorb, we're both mentally drained. Still taking it a day at a time and for today things couldn't have gone any better.
Monday, July 28, 2008
Scans and Waiting
Karen threw up this morning after the CT scan but other than that the scan was uneventful. It's probably a bad idea but she took home a CD with the images which we've poured over this evening.
It's hard to know what we're looking at so best not to draw too many conclusions.
We meet with Moriarty on Thursday assuming the radiologist writes up his report by then. The challenge is to keep distracted until then.
It's hard to know what we're looking at so best not to draw too many conclusions.
We meet with Moriarty on Thursday assuming the radiologist writes up his report by then. The challenge is to keep distracted until then.
Saturday, May 17, 2008
Radiologist's Report
This'll be a quick post as I'm typing with one hand.
Karen's doing well. Had Erbitux yesterday and gets next week off. Her scans were read and revealed she's doing well. Some things did show up such as a suspected cyst on an ovary but this is nothing to worry about.
Doctor Dan heads to Mozambique soon to participate in "doctors without borders".
In other news I cut my thumb yesterday and so this week K's taking care of me! The doctor who stitched me up as it turns out has a niece with colon-cancer, diagnosed in '98 with liver and lung mets. After resection and ablation, she's been 6 years without a recurrence. This alone was worth the trip to the ER.
Karen's doing well. Had Erbitux yesterday and gets next week off. Her scans were read and revealed she's doing well. Some things did show up such as a suspected cyst on an ovary but this is nothing to worry about.
Doctor Dan heads to Mozambique soon to participate in "doctors without borders".
In other news I cut my thumb yesterday and so this week K's taking care of me! The doctor who stitched me up as it turns out has a niece with colon-cancer, diagnosed in '98 with liver and lung mets. After resection and ablation, she's been 6 years without a recurrence. This alone was worth the trip to the ER.
Wednesday, September 12, 2007
9th Chemo Session & Scan Results
Karen is currently undergoing her ninth chemo session and all associated side effects. Yesterday we got the results of the PET/CT/MRI scans and I got a copy of the radiologist's report. This scan was compared to Karen's scan from June 1st.
Here are a few snippets from the report:
"Previously a large area of hypermetabolic activity was identified in the liver. This is decreased in size and density. The SUV values is approximately 6. The finding is considered to represent improved metastatic focus. The CT images identified calcification of this abnormality indicating dystrophic calcifications from a treated neoplastic process. The previous examination also identified small focus of activity within the left lobe which is no longer present."
This is translated as "Karen had a lot of big tumors in her liver that have decreased in size and density. The CT scan detected stuff (dystrophic calcifications) you'd expect to see if tissue was dying (neoplastic process). The tumors in her left lobe are no longer there".
"The examination now identified abnormal increased activity throughout the bones of the skeletal system. The SUV values approximately 8. Findings most likely related to a rebound effect from chemotherapy but should be correlated with history physical examination to exclude the remote possibility of diffuse neoplastic disease involving entire bone marrow. "
This either means her entire bone marrow is shot or it's a to-be-expected effect of the chemo. We are assured it's the latter.
"The activity identified within the adnexa of the pelvis previously is no longer present."
In the previous scan they had seen suspicious shadows around K's ovaries. This seems to have cleared up.
"Impression significant improvement identified. Hypermetabolic focus still noted within the liver. The lesion has decreased in size and intensity. It is in the right lobe of the liver."
Essentially Karen's tumors have shrunken but are still there. To paraphrase Dr. Dan "they aren't ice cubes that'll melt away completely".
This is GREAT, GREAT news and when we actually got to see the scans it was obvious the excellent progress Karen has made. This progress is due in large part to the chemotherapy and Dr. Dan but ultimately it has only been possible through Karen's will and determination.
The general consensus of the tumor board and associated oncologists on our team is that it's time to identify and consult with a surgeon specializing in metastatic disease and liver resection. He or she will determine the correct surgical options and we'll go from there.
I think Karen and I are a little hesitant to celebrate just yet but this is terrific news on the whole.
I have a feeling there will be a lot of "hurry up and wait" but that overall things are going to move very fast in the next few months. We remain confident that this is the best approach to treating Karen's disease.
Here are a few snippets from the report:
"Previously a large area of hypermetabolic activity was identified in the liver. This is decreased in size and density. The SUV values is approximately 6. The finding is considered to represent improved metastatic focus. The CT images identified calcification of this abnormality indicating dystrophic calcifications from a treated neoplastic process. The previous examination also identified small focus of activity within the left lobe which is no longer present."
This is translated as "Karen had a lot of big tumors in her liver that have decreased in size and density. The CT scan detected stuff (dystrophic calcifications) you'd expect to see if tissue was dying (neoplastic process). The tumors in her left lobe are no longer there".
"The examination now identified abnormal increased activity throughout the bones of the skeletal system. The SUV values approximately 8. Findings most likely related to a rebound effect from chemotherapy but should be correlated with history physical examination to exclude the remote possibility of diffuse neoplastic disease involving entire bone marrow. "
This either means her entire bone marrow is shot or it's a to-be-expected effect of the chemo. We are assured it's the latter.
"The activity identified within the adnexa of the pelvis previously is no longer present."
In the previous scan they had seen suspicious shadows around K's ovaries. This seems to have cleared up.
"Impression significant improvement identified. Hypermetabolic focus still noted within the liver. The lesion has decreased in size and intensity. It is in the right lobe of the liver."
Essentially Karen's tumors have shrunken but are still there. To paraphrase Dr. Dan "they aren't ice cubes that'll melt away completely".
This is GREAT, GREAT news and when we actually got to see the scans it was obvious the excellent progress Karen has made. This progress is due in large part to the chemotherapy and Dr. Dan but ultimately it has only been possible through Karen's will and determination.
The general consensus of the tumor board and associated oncologists on our team is that it's time to identify and consult with a surgeon specializing in metastatic disease and liver resection. He or she will determine the correct surgical options and we'll go from there.
I think Karen and I are a little hesitant to celebrate just yet but this is terrific news on the whole.
I have a feeling there will be a lot of "hurry up and wait" but that overall things are going to move very fast in the next few months. We remain confident that this is the best approach to treating Karen's disease.
Tuesday, September 4, 2007
PET and CT Scans
Karen will undergoe another round of scans tomorrow to determine the status of her tumors. She's scheduled for a PET scan along with a full torso CT Scan.
These will be followed by an MRI next week. We will get the results of all three scans next week and are very hopeful that surgery will be scheduled soon thereafter.
I am trying hard to distract myself and spent the night painting the living room.
These will be followed by an MRI next week. We will get the results of all three scans next week and are very hopeful that surgery will be scheduled soon thereafter.
I am trying hard to distract myself and spent the night painting the living room.
Tuesday, July 3, 2007
Checkpoint CT Scan
Karen's doing well. The time off from Neulasta is a blessing. 4 Chemos have been completed and yesterday Karen had a CT scan to check progress. Thanks to Dave for driving.
Whilst at the hospital she stopped by oncology and got a quick IV of fluids as she was dehydrated. Her throat developed an infection over the weekend and some antibiotics are working to clear that up.
We were supposed to get the results of the scan today but that got rescheduled to first-thing Thursday morning.
It's hard to believe 2 months have passed since chemotherapy was started. I would hardly say it has flown by but by the same token I don't remember much of it. I have no concept of time any more. Each day is blending into the next. I narrowly avoided a business trip to Brazil this week which would have put some additional strain on us. Tomorrow the US celebrates their independence from the British which doesn't really apply to me but for once I think I might just join in.
Enjoy the holiday everyone!
Whilst at the hospital she stopped by oncology and got a quick IV of fluids as she was dehydrated. Her throat developed an infection over the weekend and some antibiotics are working to clear that up.
We were supposed to get the results of the scan today but that got rescheduled to first-thing Thursday morning.
It's hard to believe 2 months have passed since chemotherapy was started. I would hardly say it has flown by but by the same token I don't remember much of it. I have no concept of time any more. Each day is blending into the next. I narrowly avoided a business trip to Brazil this week which would have put some additional strain on us. Tomorrow the US celebrates their independence from the British which doesn't really apply to me but for once I think I might just join in.
Enjoy the holiday everyone!
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