Today I met with Dr. Aragon-Ching, the oncologist with GW who supervised my chemotherapy last year. We reviewed the scan results from Fox Chase, and had a candid discussion about my prospects. She admitted that, with as bad as my post-surgery pathology had been last May, she was surprised that it had taken 15 months for a CT scan to show enlarged lymph nodes. She also said that, while there was a slim chance that the nodes were not metastatic cancer, I should not be surprised if they were.
Like Drs. Plimack and Apolo, she said that only time would tell if this was metastatic cancer. She explained that the nodes were under my clavicle, next to the brachial plexus, and adjacent to the top of my lung. It's a bad place to go probing with a biopsy needle, especially if your target is only 1 cm across. I told her that I would like to know sooner rather than later, since I likely would make certain decisions once it was confirmed. She agreed to schedule a PET scan for next week, even though it is by no means certain that it would add any more information.
She discussed chemotherapy and radiation options, but warned that none of them had been shown to be effective against metastatic bladder cancer. She said that my bladder cancer was probably platinum-resistant, since my tumors had returned and spread to my lymph nodes during chemotherapy. I told her that I did not want to destroy my quality of life suffering through treatments that had significant side effects and little likelihood of success. She agreed with me. She will work with Drs. Plimack and Apolo to make recommendations on the most appropriate course of treatment, once the distant mets are confirmed.
For now, I'm going to assume that my cancer has metastasized, and structure my life accordingly. Maybe I'll be surprised later on and feel like I have a new lease on life. But the realist in me says to not hold my breath and not hope for miracles.
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