Chemo day 73 - chemo failed; metastases found

Bad news.  Yesterday, I had a CT scan.  I picked up a copy of the report today.  It reported detecting three lymph nodes that "are highly suspicious for metastatic disease."  More ominously, it found "multilevel degenerative changes of spine are seen."  I don't know if this is due to the cancer getting into the spine, but I understand that the spine is one of the most common bone locations for this cancer to spread. 

I am still processing what this means, the ramifications regarding my treatment options, and my long-term prognosis.  I have not yet spoken with any doctors about it.  I have had extensive discussions with my family about this report, including my daughter in medical school.  Tonight, I emailed my oncologist the following questions:
 
1.  What is the meaning of the finding of spinal degeneration?  Could this be a metastasis to the bone, and if so is salvage treatment still possible?
2.  The fact that there is now lymph node involvement means that the cancer was still growing despite the chemo, right?  Is it likely or less likely that the cancer is also present outside of the lymph nodes at this time, despite the negative imaging?
3.  Should we proceed with radical cystectomy?
4.  Will additional (adjuvant) chemotherapy after surgery help the prognosis?
5.  Is there any role for radiation at this time?
6.  What additional studies are needed, e.g., spinal biopsy, PET scan, etc. 
7.  Should I meet with the radiologist to discuss? 
8.  I'm understandably eager to meet with you to discuss.  Can we set up an appointment on Monday? 

 As I get additional information, I'll post it.  I had an MRI today, and will get those results tomorrow or on Monday.  For now, pray for me and my family.