Saturday, September 8, 2012

Mixed News


After meeting Dr. A's nurse and going over all the details of giving mom her lovenox shot for her blood clot, we waited for Dr. A.  We waited close to an hour but we didn't care. We were fortunate for him to see us on such short notice.

Dr. A came in the room and started to tell us the details from the radiologist report. He told us that it seemed that the chemo wasn't working because the tumors got larger. Our hearts sank. He started to tell mom about a clinical trial that's being conducted at Mayo that might be a possibility going forward.  He also said that if mom didn't wanted to do that option, that it might be a good idea to look into homecare palliative options and hospices.

He asked mom how she was feeling and she opened up how better she was feeling the past month. She told him that she had no stomach pain anymore where it once hurt, no chest pain and she could actually eat a little now too. I intervened and confirmed that since starting this new chemo, she's overall been doing better. Outside of the chemo symptoms, things have been ok. Dr. A said it didn't make sense and then proceeded to look at the actual scans and not just the radiologist report. He pull measurements from the tumor growths but he indicated that from those numbers, the increase wasn't significant.

He ended up going into another room and projecting the scans even bigger. He compared the first, second and third (current) scan. He asked me to look at it with him.  As we reviewed and talked about the scans, we noticed between scan 1 and 2, mom's prognosis had significantly gotten worse. There was spreading to more lymph notes, and in the chest area. But,when we looked at the difference between the 2nd and the current scan we took that day, we observed very little growth. In fact, one of the tumors near the esophagus seemed a bit smaller. There was no additional metastasis that he could see.  I was pretty candid with him and said, "it seems to me that this chemo is making an impact somehow, it's keeping the cancer in check".  He told me that he wanted to speak to the radiologist and get this all figured out. He'd call me as soon as he can.

We left the clinic with a lot of uncertainty and about 10 minutes later, Dr. A called me. He said after speaking with the radiologist, that one tumor increased by 10% (if that). He said that there was no spreading either which was very good news. He said typically oncologists will state a chemo isn't working if increase of cancer is 25% or more.  And this wasn't the case in our situation. Before he hung  up the phone, he personally thanked me for making him look at this in greater detail.

I told mom the semi-good news as we drove home. I joked with her on how she's so special that throughout this whole process, she makes all these doctors look at things more than once and even have to retest.  We laughed together.


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