Twelve weeks have passed since my last CT scan just prior to Christmas. On Monday I had another CT scan of my neck, chest, abdomen and pelvis. I think that I’ve had more than 30 CT, MRI or PET scans since I was first diagnosed with bladder cancer. This time, the actual was uneventful – the tech got my vein with the first stick. Yesterday morning, a Kaiser oncology nurse emailed the results: “CT shows slight increase in a chest/mediastinal lymph node. The significance of this is not clear.” Humph. Not a useful analysis. So I got a copy of the scans on disk and took them with me to my appointment with Dr. Hahn at Johns Hopkins yesterday afternoon. He said that he was not worried about the slight increase in the size of the node, since there was no sign of metastatic activity. We both knew that the Hopkins radiologists would closely review the images and compare them to my prior scans.
My lab work was likewise unremarkable, except for a slight increase in alanine amino transferase (ALT), an enzyme that measures liver function. Dr. Hahn said that the increase was still within the normal range and didn’t see the need to take any action at this time, but we should keep an eye on it. He suggested that I do labs every month instead of every three months to see if the ALT level continued to increase. All in all, these results are not bad. There continues to be no evidence of disease. But it’s not a clean bill of health, either. So I’ll muddle on.
Dr. Hahn and I also talked about my recent appointment as a patient advocate on the Bladder Task Force, which is part of NIH’s National Cancer Institute Steering Committee program. The BTF regularly reviews proposed clinical trials relating to bladder cancer. My job is to look at the proposals from the viewpoint of a patient – e.g., would this be a trial that would be attractive to a patient, as opposed to the standard of care; what is the likelihood of a substantial benefit; how can the investigators reduce the burdens on the patient; etc. Dr. Hahn encouraged me to speak up and remind the MD’s and PhD’s how it feels to be on the other end of the needle. “Sometimes researchers get caught up in the science and lose sight of the patient,” he said.
In other news, the spring real estate market is heating up. In the past two weeks we’ve received two offers on our house. We rejected a lowball without bothering to counter. We’re preparing to counter another one. We’ll see what happens. My more immediate concern is shoveling the 6-8” of global warming that has fallen on this second day of Spring.