Monday, May 03, 2021

Time to go BACK to War

 I had a consult with my oncological surgeon... and it was pretty bad news. 

What it comes down to, is about an 85% chance that I'll be gone within a year, and about a 15% chance of survival. 

I'm attaching two pictures here. These are frames from my PET scan with contrast. The hotspots circled in red are definitely cancer, that we already knew about. 

Those are in my neck. The rest, are in my lungs, and that's the problem.

The hotspots in green, are almost certainly cancer... That we didn't know about until the PET scan. It's not confirmed, but it isn't just a hot spot on the contrast, there's also some visible structure in the CT... it's about 85% certain that its cancer. 

... And this cancer would be inoperable. 

The orange hot spots are potentially cancer, because of the hot spotting, but they don't have much or any structure visible in the CT without contrast. They're only about 15% likely to be cancer. However, if they are... then they're likely not treatable, and I likely only have a few fairly unpleasant and painful months left to live. Less than a year certainly. 

If the only new cancer is the green, then theres a good chance that I am a good candidate for immunotherapy. My care team is consulting with several different oncology specialists now, and will get back to me soon with potential treatment options. 

My next year is... likely going to be very difficult, and very painful. If the treatment works, great... but it's gonna REALLY hurt the entire damn time.

I'm not sure how much longer I'll be able to work... My plan is to work as long as I can, and then try to use my short and long term disability insurance... See how that goes.

But what it comes down to... is that I'm probably dying. 

If that happens... I'm OK with it. I came to terms with that back in 2012 when I had just a 4% chance of surviving. 

But my plan, is to survive, at least long enough to see my son graduate college... and he's got another at least 14 years to go... so... time to go back to war. 


I had my first meeting and first sample collection for the first series of genetic testing, with my new oncologist. 

She's one of the leading oncologists in biologic and genetic immunotherapies. The good news is she thinks that yeah, the large defined mass circled in green is almost certainly cancer, but there's a good chance the orange stuff is either not cancer, or is not sufficiently advanced that it I wouldn't be a good candidate for immunotherapy, and that I have a good chance of responding well to it. Maybe double or triple the chance of surviving a year or more than my surgeon was thinking... 

...If... and it's a BIG IF... 

...the genetic testing comes back showing that I am a good candidate and the cancer is the right kind of cancer with the right genetic and molecular makeup.

Oh and yeah, there's apparently new kinds of pathology and new kinds of molecular testing of the cancer tissues that helps them tailor the treatment exactly to your cancer, with biologic or genetic immunotherapy. 

I'm having a biopsy in the next few days or week and they'll send that tissue out for both genetic and molecular analysis, as well as conventional pathology. Those various series of tests are going to take 3 to 6 week.

So... yeah... I'll know more in 3-6 weeks.