Saturday, August 25, 2007

Cancer in Lungs

I got a second opinion on the scans and the conclusion is that the cancer has spread to my lungs.

The doctors said the right lung wasn’t a question. They thought the PET-CT scan lit up the cancer on the right lung pretty well. The question was whether the lesion in the left lung was also cancer. Given my scans (from March 2006 to August 2007) and the progression of my disease, they concluded that the left lesion was also most likely cancer.

There’s a slim possibility that it’s an infection. If that’s the case, after several more cycles of chemo, we’ll do a scan and have a better guess. If the scan shows the lesions on both lungs are gone, then we can assume the chemo worked and killed the cancer in both lungs, OR we can assume the chemo killed the cancer in the right lung and the infection in the left lung resolved itself. If the lesions on both lungs are still there, we’ll know for sure the left lung was cancer since an infection would’ve resolved itself after a few months… and we’ll know the chemo didn’t work.

The doctor explained that because lungs are constantly moving, any lesion would have to be pretty large to show up on the PET scan. If the same lesion were on my shoulder, we’d be able to see it on the PET without a problem. But on the lung, the lesion would have to be much more pronounced for it to show up on the scan. That’s why we could see it fairly well on the CT scans, but it didn’t light up on the PET. Also, I learned that the CT part of a PET-CT scan doesn’t show as much as a dedicated CT (or CAT) scan. The latter is usually done with a contrast to show up the tumor better on the film, much like the radioactive tracer used for the PET.

The scans were reviewed by a radiologist and a radiation oncologist at an entirely different hospital from the one where I’m being treated. I’d already gotten four radiologists and oncologists at my hospital to weigh in their opinions, so I think I’m being pretty thorough. What the doctor told me today just confirms my gut feeling that the cancer is in my lungs. I had thought it, and almost felt it, all along.

For the past few days, I’ve been feeling pain in my chest, neck, and the area next to my right shoulder blade. It’s discomfort more than pain, although every once in a while, I get a sharp, shooting pain that makes me grimace a bit. I don’t mind the pain; what I mind is what the pain represents. Every time I get that stabbing feeling, I worry that it’s the cancer cells having a huge party and multiplying like mad.

I’m so worried about the cancer spread that I want chemo again right away. I’m worried that my blood counts might be too low for chemo on Monday, so I ate meat again tonight – the third time since my first chemo on Monday. That’s more meat than I’ve had in about a year.

I hope I can go ahead with my next chemo session Monday and that I start feeling some response. The pain subsided just after the last chemo session but it’s come back stronger now. So I’m worried that the cancer cells took a beating from the chemo, but have since come fighting back and perhaps have even developed a resistance to the chemo and can do even more damage to me.

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