Mets Day 573 - Labs and CT scan results

Today I went to GW for lab work and to meet with Dr. Aragon-Ching.  My counts were consistent with my prior results for one week post-chemo -- low, but basically okay.  I also reported that, after nearly a week of painful constipation, I could report a splashdown from some astronauts.  I told my oncologist how relieved I was to be taking a break from chemo.  I told her how we'd decided to book a last-minute cruise after I'd decided to stop after three rounds, and she was genuinely happy and supportive of my decision.  We agreed to circle back after the holidays to see where we were, unless something bad happened in the meantime.

As of my midday appointment, neither Dr. Aragon-Ching nor I had heard from Dr. Apolo regarding the results of yesterday's CT scan.  That came this evening, when Dr. Apolo called with good news.   She said that the CT scan did not detect any additional distant metastases, including the liver, which was a potential area of concern from the August PET scan.  She said that the node in my neck measured .8 cm, which is essentially unchanged from the 1.0 cm  (10.2 mm to be precise) in the August scan.  Because the CT scan slices at every .5 cm, the difference between .8 and 1.0 cm could be the result of a slightly different CT slice of the node, and she could not definitively conclude that the node in the neck had actually shrunk as a result of the ddMVAC chemo.

We discussed my decision to put on hold further chemo rounds for now.  Dr. Apolo said that I had been tolerating the chemo very well, which was news to me.  She then explained that, by tolerating the chemo well, she meant that I had not required hospitalizations or blood transfusions.  She also said that a full ddMVAC regimen was typically six rounds, and by stopping now, I was not doing the full regimen.  She said that the best possible outcome of ddMVAC was total remission, then immediately added that happens less than 5% of the time.  She implied that, by not going for all six rounds, there was less of a chance of a full remission.  She then said that it was my decision, and she would support my decision either way.

The way I see it, the odds of full remission are remote.  A full remission means that once detectable distant metastases is no longer detectable.  So far, the ddMVAC chemo has not shrunk the node in my neck.  If that hasn't happened after three rounds, it's probably not going to happen after three more.  On the other hand, there has been no additional growth either.  But there is no way of knowing whether that's a result of the ddMVAC, or just that my cancer is taking its time, or divine intervention, or eating Entemann's donuts.  What I am certain of is that, if I were to continue chemo, I'd feel lousy for another two months, I would miss the chance to celebrate my 30th anniversary on a cruise in two weeks, and the holidays would not be nearly as bright.  I'm comfortable with my decision.

Dr. Apolo agreed that she'd do another CT scan in January.  She also said that she had put in a request to have my tissue sample from the biopsy run through NIH's gene sequencer, so we'd have that information at our disposal if and when I have enlarged nodes and become eligible for one of the gene therapy clinical trials.  While gene therapy looks like it is the new frontier for cancer treatment, I hope that my nodes stay small for a long time.