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Posts Tagged ‘CT scan’


Round 2 and a scan.
August 9, 2014

Round 2:  August 5, Tuesday.
If you have to have a hobby while waiting in hospital waiting rooms, choose knitting.  It seems to be the universal thing people do in the waiting rooms and lobbies of Mayo, MD Anderson, and here at UofC.  I am not into knitting but I appreciate them, sadly there are no apps for that.

Sammy was there again greeting me in my assigned room.

“Hello.  Hello.  How do you feel?” in accented English.  I replied that I was feeling good and joke him that he should be into running because he from West Africa.  He just gave a big laugh.

We started late because the trial drug arrived late at the center.  It just means a longer day for me.  I was among the first to arrive at the center in the morning and with the delayed arrival of the meds I maybe be the last patient.  Oh, well.  This infusion center is really busy.  Patients come in, have their chemo, and go home.

While at the waiting lounge, an elderly black couple took up conversation with the people they were sitting across.

“You must be together for many years now?  We  have been been together for almost 68 years and was engaged for 4 years before that.”  Wow.  The wife was the patient while the husband dutifully attend to her slowly.  You would hate for cancer to interrupt their marriage.

Such is life or rather the fragility of it.  It can be interrupted anytime without notice.  But those things are further from everybody’s mind at the waiting room.  Cancer is just…an interruption.  This is our new normal.  The waiting room could have just been another breakfast gathering where people know each other, including the nurses and technicians.  Greetings are warm and pleasant.  Conversations here are open but tempered.  Each is curious as to what type of cancer the other one has.  Each has their own way of coping.  None of us wants to be here but we are here.  We make the most of it.

“Same protocol, Mr. Alvarez.  First the pre-meds then the chemo.” Sammy said.

As the pre-meds take effect, I sink again to la-la-land….zzzzz.  Lab rat number 5 is down again for the count.  I wake up a couple of hours later, groggy, and hungry.  Although the infusion is done, I still have to stay because of all the monitoring and blood test (many blood tests).  My wife and I move back to the waiting lounge and the crowd has thinned.  True enough, I will be among the last patient to close before everybody leaves.  Long day.

The scan: August 8, Friday.
After two rounds of chemo, it is time to see if I am responding to the treatment by doing a PET scan.  These tests are pre-scheduled so all I need to do is show up.  You really feel like an experiment when you have tests lined up for you.  You do not have any control of what happens next during the trial but I also know it is for my benefit…and others.

PET scans as are easy and I have done this many times.  They infuse you with radiated sugar and you just sit motionless or sleep (more zzzzz’s….) for an hour or so.  The idea for the cancer cells to absorb the sugar and scan them for size and activity.  CT scans has more discomfort because they make you drink this prep drink, infuse dye in your blood stream, and then scan you.

Like all tests, it is the results that always drive the anxiety.  In my case I have to wait perhaps until next week for the results.  We are looking for a response to my treatment; a reduction in the size of my lung tumors or their numbers.  Thanks for all the positive thoughts and prayers.

Cheers.

P.S. I had hiccups again after treatment.  Have been recovering good enough to maintain running.  For this weekend, will aim for at least 10 miles again.

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Clinical Trials:  I am in.
July 25, 2014

II am number 5.  That number looks like the number of an elite marathoner, but it is not.  It just means I am the 5th participant to this new anti-cancer drug.  Yes, I am in … for real.  I count myself among the select few to undergo this human trial, and I start Monday, July 28 at the University of Chicago Medicine.

The objective is to determine the safe and effective level for this new Phase 1 anti-cancer drug that address the RNA part of cell molecular structure. Don’t ask me explain, it is complicated.  All know is, it was first tested in mice and monkeys with positive results and now they are trying it on humans.  Guess what: I am the 5th “sucker.”  Ha!  I love it.

This trial is different from the one that was offered to me in April (see A Different World: Part 1 and Part 2), wherein I did not even get to start because of my platelet problems.  However, from what I am told this new trial is a better fit for my profile and that they are getting positive responses from the other trial participants.  That’s good to know.  Frankly, my options are not exactly a lot: either I do trial for a chance of another tomorrow or just give up.  I have tried all the other traditional chemo regiments and I am now immune to them.  I am willing to participate in this trial just to conquer my cancer.

Last Wednesday, I did all the pre-trial test such as: blood test, EKG, PET scan and CT scan.  With my platelet up (thanks to MD Anderson) and other blood work looking good, they allowed me to start Monday.  My start date would have been end of August, but the drug sponsor liked the initial results and decided to accept more participants.  It will also be chemo infusion and would require me to stay long at the hospital.

Well I am ready.  Since coming back from MD Anderson, I have been working out, running, and keeping active.  This cancer has brought me all over and tested me at every turn.  Cancer is my reality; the life I live through everyday is the dream.  I have so many wishes but I temper my expectation to what I can achieve or get.  That’s why it is better to live your life one day at a time.

Monday is marathon day for me.  My bib say number 5.  I know there could be problems ahead, right now all I want is to finish..in one piece.

Start

Cheers.

P.S.  My miles are slowly building up again.  Tomorrow let see if I can do 10 miles.

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The results of my scan
November 10, 2013
Dallas, TX

The results of my CT scan came out Friday, November 8.  It is funny how you receive news now a days.  You can breakup on Facebook or email.  News of my results came by text from my oncologist.  He said:

 

“Ct scan showed stable if anything there is improvement of lung nodules.  Gd news.”

With that I showed it to my wife and mom, and we all hugged.  My mom was more emotional.  I can feel her mother’s love: she has witnessed, from near and far, all my ups and downs over the years.  It is from her I draw strength when I feel weak.  At her age, she does not have to take care of me or witness my struggles, and yet she is there.

My oncologist and I spoke on his next plan for me.  He and I know, he is running out of options.  For almost six years, he has given me all the chemo drugs available for my type of cancer.  Some put me almost to the edge of death, while others gave me allergies and complications.  They have infused me with it and I have taken it in pill form.

He also knows, I would like to seek another opinion at MD Anderson in Houston, TX.  I initially wanted Memorial Sloan Kettering in NYC, where they are using IBM’s Watson for cancer research, but they were not responsive.  Initial feedback from MD Anderson was I go on clinical trials because I have practically received all the applicable chemo drugs, and in large quantities. However, they cannot see me until I finish my current treatment and see the results of my scan.  

Weill it is out.  It showed persistent, possibly improving bilateral pulmonary metastatic nodules.  In english: it is still there, did not grow but improved, and still present in both lungs.

It takes a lot of energy for me to earn a day.  I am not like others who’s tomorrow is almost guaranteed.  It is a given for them to finish the race in quality time, while I struggle to run mile after mile.  And when I do reach the finish line, I find out they moved it again.  This time they moved it to Houston.

Cheers.

P.S. October 18, IBM Watson is now in MD Anderson to be used for leukemia studies.  I wish they had started with colon cancer.  Oh well.

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Life has a way of changing you.

January 13, 2013

F

inally, it is here.  I could get my Downton Abbey Season 3 fix.  If you are one those who follow this TV drama in PBS you know the feeling.  It is unfair that First Lady Michele Obama got to see the whole season ahead, oh well.

I don’t watch too much TV but I make an exception to Downton Abbey; besides it is commercial-free in PBS, which is home to Big Bird…if you know what I mean.  (Note: For my international friend, during the debate on tax cuts, the Republicans threaten to cut funding to PBS, home of Sesame Street: Big Bird and his friends.  Don’t touch Big Bird was the cry).  The TV drama series has a huge following here in the US.

I am a history buff and this was set during the Eduardian and post-Eduardian era.  It follows the lives of the aristocratic lives of the Crawley family.  The one thing that held my interest in this TV drama is the crisp, subtle and meaningful dialogue; and the intriguing character.  So when the butler Mr. Carson said in one of the episodes (in monotoned English clip):

 “Life has a way of changing you.”  It hit me.

Life has force me to changed.  I, at times, would look back at my long journey and compare my life before cancer and my present one.  I have definitely change for the better inspite of the things I have given up, like red meat.  You have to change to get better and find out more about yourself.  Sometimes you have to fears in order to improve or get the most out of life.  It is like jumping out of an airplane to face your fear of height, right?

My fear is my mortality.  I get tested with it every other week during chemo, which I cannot get use to.  However, when you look at the long road I have taken since March 2008, I have survived them all.  I have made so many friends along the way.  I have discovered myself and I think you have too with the stories I tell.  I am glad that I have changed because I am able to appreciate life more fully now.

I have another milestone coming: re-staging my cancer.  This Thursday, January 17, I will have my CT scan to verify if I am responding to my current treatment using the new chemo drug, Zaltrap.  Oh yes, I have done many scans before and I also have received good news and bad news from the results  This time, I am hoping for good news that my nodules are gone or at least have shrunk.  What can I say, except thanks for your support and prayers.  Will let you know.  Onward with my real-life drama.

Cheers.

P.S. NYC marathon have opened up the registration for 2013 for those who were not able to run the canceled 2012 marathon.  I will decide if I will run 2013 after my scan results.

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I thought I escaped.

October 27, 2011

n my mind I thought I escaped by leaving for Atlanta, but in the end I think it was just taking a detour to the same destination: chemo treatment. The results of the CT scan still bothered me so I called up Dr. B, the radiologist who read my July 28 PET scan.

I had gotten to know Dr. B when he did my chemoembolization(or targetted chemo) December 2009 (see related post ‘At the starting line with Dr B‘).  He is a very warm and caring doctor who is thorough with his work. He said he was disappointed when he saw my July 28 PET scan showing the suspicious nodules in my lungs.  I told him the reason for my call.

Dr. B, can you tell me which of six nodules discovered last July 28 grew when compared to the October 20 CT scan?  The October 20 report just said ‘representative nodule’ measures 1 cm,” I asked nervously.

He ticked off the growth of each nodules with a professional tone:

6 mm to 7 mm

8 mm to 10 mm

9 mm to 11 mm

3 mm to 5 mm for the nodule on the right.

Each time he gave me the comparative results, it felt like a stab to my heart.  Breathe. I lost count.  It was like pounding nails sealing my faith, forcing me to accept reality: it is back.

It is conclusive, Bo.” He solemnly said. I thank him for his openness. Also, he does not think another PET scan will be helpful.  He just advised me to have a discussion with Dr. M on my treatment plan.

It is back to chemo for me. It is like, I am being told to go back to the back of the line because you have not learned. I maybe missing the point of this lesson this time or it maybe just hard to see it at the moment. Do you get it?

What my muscle memory tells me is just to stand up, move, and never give up until I finish this challenge.  But chemo treatments are not marathon races.  They are unique by itself. There are no endorphin highs or no medals to show.  There are even no winners or finishers, just survivors. In the end, there are just those who are with us or those who are not.

I will commit myself to this again.  What else is there to do.  I will be at the starting line again on November 8.  Please come with me again.

Cheers.

P.S. I entered a half-marathon race this Saturday, October 29, here in Atlanta.  It is called the Silver Comet.  Let’s see what they have here in Atlanta besides peaches.

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Facing reality: Lung CT scan.

October 18, 2011

short posting.  My oncologist’s office called to say that I have been schedule for my chest and abdomen CT scan Thursday morning, October 20.  Gulp.  We will now find out if the six nodules in my lungs has grown or multiplied when compared to my last July 28 PET scan (see related posts ‘Its not there‘ and ‘The plan‘).  All bets are in.  Should there be any cancer activity, I am sure the verdict will be six-months of hard chemo.  I am hopeful, and praying for the best.  My blood test last week showed my CEA (tumor count) level is stable at 1.7, which is under the 2.5 threshold.

“Be sure to pickup the barium sulfate contrast so you can drink it the night before.” I was instructed.

“Ok.” I grudgingly replied.

Great. Just in time for Halloween, I am my own ‘glow in the dark’.

Cheers.

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It’s complicated*

April 12, 2010

(*Footnote: The title of this post reminded me of the 2009 movie ‘It’s Complicated‘ starring Meryl Streep, Alec Baldwin and Steve Martin. Most often, it is also used as common American expression to describe a difficult predicament/situation.)

As if saying why does life have to be complicated?

————————————-

ast week Monday (April 5), my wife and I found ourselves in the patient room waiting for Dr. A, the liver surgeon (see related post ‘Meeting Dr. A‘). This appointment was already set several weeks ago to assess the resectability of my liver. The previouls week (March 31 and April 1), I had a series of scans of my liver, chest, and whole body (PET).  The PET scan came out negative with no cancer cells detected, soI was curious to find out what Dr. A would recommend.

“Wow. You look burnt, Dr. A. I hope you had fun!” I jokingly said upon seeing him walk through the door.

He smiled and said “I took in too much sun while on vacation in Arizona.” I suppose you forgot to put sunblock. 🙂 We exchanged further pleasantries and then he got down to business.

“As I had previously mentioned in our last meeting, we have a surgical review team that go through all our cases every Friday, and your case was among those reviewed.  For your case, it was reviewed by the radiologist, oncologist, and surgeon. They reviewed the results of your scans and medical background, and came to the conclusion of surgery to resect the tumors in your liver.”

There it is again. Reality looking me in the eyes. I could not reconcile in my mind why these learned doctors would recommend resection of my liver when my scans were negative. Why? Seeing my apprehension, Dr A. continued.

“I understand that the PET scan shows negative presence of cancer cells. To me this is the litmus test of the resectability of your liver.  The negative PET scan, tells me you have responded to your chemo treatments. If you did not respond to your treatments or your PET still showed positive presence of cancer, it is useless to resect your liver. No point in opening you up when you don’t respond to chemo.  It does not buy you anything.”

Ok. That make sense.

“Also, the negative PET scan results does not mean that your cancer is not going to come back.  For now, nothing can be detected or identified.  A resection of your liver would increase your chances of remission or the cancer not coming back. I know this is a lot to absorb, so you might like to think this over before deciding.”

He gave me other details of how long is the recovery period and if it will be partial or full resection. Right now he is looking at an open surgery to take out the right lobe of my liver. Gulp! Recovery is about four weeks in order for the left lobe to grow and take over. I would have to give up drinking or drink in moderation since I am left with one lobe.

This is complicated, but if you think about it I am being given an opportunity to increase my chances of remission. My right lobe for a better life. It is no different from the choices given up by other cancer patients, like LisaK, a breast cancer survivor of 11 years. Lisa is my yoga-mate and I recently got to know her more.

She is a graphic artist and entrepreneur with her own company (Pisa Design).  Eleven years ago, she was in the same predicament I am in now.  To increase her chance of remission she had a double mastectomy; moreover,  she even went further to have her ovaries removed. Now, how does that compare to me giving up drinking and her giving up up the chance to have kids of her own?  Cancer makes give up things for a sliver of hope of remission.

You have to give up something in order to get something of value. Sounds familiar. It happens everyday, like paying for goods and services; but put this into perspective of something of real value.  It is like giving up something for a chance to smell the roses for many more years, hold hands with your wife or love ones, a chance to see one more sunrise, or a chance to stand at the starting line of the NYC marathon or London marathon. Would I give up a liver for that?

Yes, I would.  It is not complicated.

Cheers.

PS: I would know in the coming days when my liver surgery will be. For now, I being weaned out of chemo toxins in my body. To help in getting rid of the toxins, I am running, cycling, cross-training, and doing more yoga.  Hopefully, I will have an easy recovery from surgery, as well.  I will keep you posted.

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