Monday, March 23, 2009

Not good news

Based on how Rebecca has been feeling and how her symptoms have been, nothing here is a great surprise, to us. First I will give the cliff notes and then, for those of you who like a challenge, I will include the radiologists report so you can get your favorite oncologist to give an opinion on the treatment plan.

Following a marked increase in the CA 15--3 (up to 188, the highest ever) Rebecca had a CT with Contrast of Thorax, Abdomen and Pelvis. The results of the CT were unambiguously bad. Some of the news includes: growth of everything that was already there, the addition of more suspicious stuff in the lungs and some liquid build-up around the right lung. The big kicker of the report is the first spot of cancer on the liver.

At this point we have to conclude that the Faslodex is not being effective and it is time to move on in the treatment plan.

Next course; Taxol. This is a 'low nausea' chemo. Taxol is a 3 week on, 1 week off treatment plan. Rebecca will lose her hair.

We hope, given the level of fatigue that Rebecca has been experiencing due to tumor load, that the change in treatment will not make her feel any worse. The HOPE is that the chemo induced fatigue will be off-set by reducion in cancer induced fatigue. This SHOULD also reverse the trend in increasing discomfort doing things like... breathing.

We have to schedule the first chemo... I'll keep you posted.

THE DRY FACTS:

Performed after oral contrast and 120cc of Omnipaque 350.
Compared with the study of 1/13/09. A 7mm slightly irregular nodule has enlarged slightly along the left diaphragm, and a 4mm pleural based nodule along the left pleura at this same level. A patchy 8mm triangular density has appeared along the pleura on the left of image 42. An infiltrative lesion has appeared in the superior segment of the left lower lobe on image 32. A spindle shaped desity along the left major fissure has enlarged slightly.

Any or all of these are suspicious for metastatic disease.

Several small suspicious densities have also appeared in the right lung. A band of tissue extending accross the right upper lung has enlarged into a rounded frank mass measuring 6.7 * 6.0 cm in diameter. It narrows the right upper lobe bronchus. The right pulmonary artery is also moderately circumferentially narrowed by this right upper lobe mass and right hilar and subcarinal adenopathy. A small right pleural effusion has appeared. Left supraclavvicular adenopathy has increased slightly. No bony metastases are identified. A right apicardial lymph node has grown to approximately 2.8cm in diameter, from 1.9 cm previously. A spherical 1.8 cm low density lesion has appeared on the left lobe of the liver., on image 55, consistant with a metastasis. No evidence of ascites or adenopathy in the abdomen. The known pericardial effusion has increased slightly in size, and is now small to moderate in volume. No evidence of ascites or abdominal adenopathy.


Say that 3 times quickly!

1 comment:

Denise Wolf said...

I'm sorry guys. I'm sure this was really hard to hear, even if not that surprising given how you've been feeling. But I have a strong sense that the Taxol will work wonders and shrink all those guys back to something less burdensome. When your lungs clear out, you will feel much, much better. Chemo worked really well for you before, and there is no reason why it shouldn't again. And Taxol won't be too hard to deal with, I bet. I had Taxotere and Carboplatinum, and aside from a few days a month, it didn't really throw me much physically. Well, whatever happens, we are here with our arms around all of you.

Much, much love,

Denise