February 2010 test results

On Monday, Feb 22, 2010, Carl had two MRI's and a CAT scan to see how the tumor is responding to the radiation and chemotherapy. The MRI's were on his leg and neck, and the CAT scan was on his chest.

Returning to the theme of tests in High School and College: In school, when you got your test back, you would understand the meaning. To make it easier, the tests could even be scored A, B, C, D or F. I guess I wouldn't want the medical community to score medical tests this way, but I can say that it might make understanding tests results easier.

Carl's CAT scan result is the easiest to understand. Previously (Dec 2009) Carl had two small nodules of (presumably) tumor in his lungs. Now the results state "Right upper lobe nodule has shrunken considerably. No other nodules are visible."; and "no new nodules".

The tumors in his leg and neck show signs of some shrinkage: As the report says - "Slight interval decrease in the size overall." (Specific, hey? Is that an A, B, C or what?)

I got a sort of insight on Sunday. The tests, and test results, aren't really for the patient. They are for the Doctors, who will now review the treatments to date and their effect on the tumor. The Doctors will then get down to the business of refining the treatment plan. This review will probably happen at a tumor board on Wednesday, March 3, 2010.

When Carl and I were presented with the facts of Carl's sarcoma in December 2009, the Doctors we saw suggested that Carl would be "in treatment" for all of 2010. "Treatment" would consist of radiation, chemotherapy, and "local control". Local control consists of surgeries, Gamma knife procedures, laser ablations, procedures for removing the tumor, etc.

Of course, if the chemotherapy worked wonders, and killed the tumor quickly, Carl might get lucky and not need "local control surgeries". Carl might be able to not require treatments for all of 2010 and beyond. The Doctors indicated that this was a possible, although not likely outcome. This is what I was praying for.

I was hoping for a miracle. I wanted the chemotherapy to be a quick fix and melt all of the tumors away like butter in a microwave. This may have happened (did happen?) to the small tumors in Carl's lung, which means that Carl has avoided one or two small "local control" surgeries to his lungs. (Yeah!) [Had the lung spots required surgery, the lung spots might have been removed on separate weeks to allow for better recovery. Lung surgery may mean (usually means?) that the lung will collapse and have to be re-inflated, which carries risks with it. Avoiding a lung surgery (or two) is good.]

So Carl has avoided 2 local control procedures, but ... ???

While it is still a possibility that the tumors will shrink and melt away, the current results might suggest that Carl's tolerance for the chemotherapy will run out BEFORE the remaining tumor is gone. That means longer treatments, more radiation, and more "local control". Treatments for all of 2010. Bummer.

For now, Carl is still tolerating chemotherapy well, and on Monday, March 1, 2010, he started Round No. 4 : Inpatient Chemotherapy at Froedtert Hospital on the 4th floor North Tower. He should get out on Friday, March 5, 2010. May this treatment wither away the tumor in his leg and neck.

Somehow, I felt a little more hopeful before the test results came out, even though the tests indicated nice results. I wanted miraculous results.

I guess the miracle is that, in 2010, in the United States, close to our home, there is an arsenal of treatments to throw at the sarcoma tumors, and that Carl is here and getting those treatments. Many others in the world would not be as fortunate.

Hang in there Carl! I am praying for you! And so are many others!

Thank you to all who are praying for Carl.