CR 917: A reminder of how quickly things can change

Last week I had another CT scan at Kaiser. That afternoon the Kaiser nurse told me that the scan looked fine, with no evidence of metastatic activity. Two days later I drove up the Hopkins to check in with Dr. Hahn. He likewise saw no metastatic activity, but noted that my supraclavicular node (or a collection of two or three nodes) had increased in length by 3 mm. The node that showed up on the scan is the same location and the node that first started showing metastatic growth back in August 2013. It’s the same one that was biopsied in September 2013 to confirm my distant mets. And it’s the node that has shown the greatest elasticity, growing to over 4 cm in March of 2015, then shrinking to almost nothing by the end of the year.

The node did not “light up” in response to the contrast, so there is no indication that there is active cancer growth. But it was bigger in size. Maybe it was the way it was sliced in the scan, or maybe the nodes have sort of fused together, but it was the first increase in size of any of my nodes in more than two years. Dr. Hahn didn’t seem bothered by it, however, and we talked about increasing the time period between scans from the current 12 weeks (the duration I’ve been maintaining for more than 5 years) to 16 weeks. He and the new Hopkins clinical trial nurse are going to check with the trial sponsor (Bristol Myers Squibb) since the trial protocol is unclear on whether the duration between scans can be increased and the patient data still be included. I’m fine with whatever they decide.

So the report is good – no sign of metastatic cancer – but it’s a reminder that the durability of my remission is uncertain. I continue to sail through uncharted waters, with no one having gone before me to provide any expectation of what lays ahead. Stay tuned to see if I discover dragons or sail off the edge of the world.

In other news, two weeks ago I totaled our car in West Virginia. I was driving in Blackwater Falls State Park soon after a glazing of snow, tapped on my brakes as I was entering a curve, hit black ice, slid down a hill and crashed into the side of a large culvert. I was with Jennifer, Spencer, and Nephi, and fortunately we just got some bumps and bruises. But it was another reminder of how quickly life can change. I was grateful that all of us were able to walk away. I'm also grateful for the good in the world, and for the spiritual gifts during this holy season.