Mets Day 875 - My cancer is slowly growing

This afternoon I received a call from Dr. Apolo with the results of yesterday's PET-MRI scan. She reported that the scan provided excellent images. The good news is that the scan did not reveal any tumors in my organs. The bad news is that the scan showed that the cancer is slowly growing in the same group of lymph nodes near the base of my neck, where the distant metastases was first detected in August of last year. She reported that the scan showed that the size of the largest node was 1.5 cm in the long axis, and 1.35 cm in the short axis. She said that the scan showed that there was a cancer tumor growing within that node, since the scan showed uptake of the 18F-flouride glucose. She added that other nodes in the area were also slightly larger in size than was reflected in prior scans. This means that my metastatic cancer was not sterilized by the dose dense MVAC chemotherapy that I had last fall, and has resumed its growth in my lymphatic system.

Dr Apolo said that there was no standard therapy that she would recommend at this point. I've already had two rounds of cisplatin-based chemotherapies, and my cancer had been shown to be cisplatin-resistant. She said that the most promising therapy would be an experimental immunotherapy, which is available only through a clinical trial. The standards for entering such trials, however, are that the tumor has to be at least 1.5 cm in size on its shortest axis, and mine is just under that size, at 1.35 cm. She recommended waiting for a couple of months, then having another scan. In the meantime, she would review the various clinical trials available, and we can discuss the pros and cons after my next scan.

Although I already knew the answer, I asked whether removing the nodes would have any beneficial effect. Dr. Apolo replied that studies had shown that there was no therapeutic benefit to removing metastatic nodes, because the cancer was spread throughout my lymphatic system.  Removing the nodes would not slow the spread of cancer to other parts of my body.

This news is disappointing but not unexpected. If anything, the surprise has been how slowly my mets has moved. Maybe it will continue to grow slowly. Maybe we'll find an experimental therapy that can slow or even reverse it (although that's a long shot). The most likely outcome is that it will spread like, well, a cancer, and eventually overwhelm my body. My hope is tempered with reality, but my faith remains unshaken:

Oh that my words were now written! oh that they were printed in a book!
That they were graven with an iron pen and lead in the rock for ever!
For I know that my redeemer liveth, and that he shall stand at the latter day upon the earth:
And though after my skin worms destroy this body, yet in my flesh shall I see God:
Whom I shall see for myself, and mine eyes shall behold, and not another; though my reins be consumed within me.