I spent the time between my CT scan and MRI Thursday AM and our meeting with my oncologist Friday AM trying my hardest to think of a descriptive phrase for that time period in ongoing cancer treatment or follow-up, because It’s a Thing. It’s the scan-results interval (SRI?). It’s the DFWP, the dread-filled waiting period. It is the time when I worry the most, though that makes no sense. Whatever the cancer is doing, it was doing it before the scans…it’s not like the scans determine what is going on. And yet. I am pretty good at Not Thinking About It before the MRI & CT appointments; very good at not worrying during the scans themselves; and then a gray overcast hovers over my life until our appointment with the oncologist a day or two later.
Like “chemo brain,” this aspect of the cancer lifestyle deserves a catchy name so we can talk about it. Suggestions welcome.
So what is going on, the unvarnished update: the CT scan showed no changes, but the MRI showed 3 new 4-5 mm “spots” in my brain.
Now for the varnish: the CT scan is very good news because it means the chemo is still working (10 months & counting): the tumors are not growing, and no new ones have appeared anywhere. So that is really good. And it buys me 3 more months of the chemo regimen I am used to (until the next scans). The new brain lesions are a) very small, and causing no swelling or anything at all; b) apparently not in tricky places; and c) not in the same places as last winter’s. In other words, they are a new mini-crop, not the old ones growing back. This means it’s very likely that they can be “zapped” with another treatment of stereotactic radiosurgery (SRS), like the January zapping but less extensive.
My oncologist said he likes to look at it as: “we are in a better place right now than we were in January.” (January, for those of you tuning in late: 3 spots, one big…no, 4…n0, 5 spots, one big and one tiny but in a location hard to reach safely; lung and bone tumors that might or might not respond to the chemotherapy we had just begun to try; no evidence that the brain lesions would respond to SRS; no good evidence for the rate of growth of the cancer.) His “better place” is defined by: smaller and fewer brain lesions this time around; we know SRS worked on the others so we can be pretty sure it will work on these; it took a while for anything new to show up in my brain so the rate of growth is not devastatingly fast; and chemo has worked well and is continuing to work well outside the brain (no one expected it to get into the brain), meaning no new tumors, no growth of the existing tumors, and all of this “holding steady” is happening in a state in which I have no symptoms from the cancer. Peachy! Shiny. Varnish!
I said “But compared to August’s results, well, I’ll take August.” He said sure but don’t compare the lows to the highs; he compares the highs to the highs and the lows to the lows. Doubtful look from me elicited “That’s how I do it, and I’m sticking to it.” Okay then, if that’s how you keep doing this job week after week, year after year, patient after patient! Go for it.
So the paint-stripper version: no miracle is happening. All the things I’m doing besides chemo to make my body less hospitable to cancer are not working 100%. I’ll never know whether that means I should be doing more of those things, or whether they are having no real effect at all. Am I using my brain too much? Maybe I need more episodes of “Bones” and fewer abstracts of Phase II studies about copper depletion therapy’s effects on metastatic TNBC. Meanwhile my schedule for December is up in the air while I experience another Cancer Interv-hell: so far all of this is from my regular 3-month surveillance MRI and the oncologist’s best guesses, and I haven’t talked to the intervention radiologist yet, the one who does the SRS. So nothing is for sure yet, though Eric and I are both sure that we floated this scenario past the radiologist in January and he said SRS could be repeated. Perhaps he will call my cell phone to discuss my brain mets and penetrating my head with radiation while I try to choose organic breakfast cereals in the aisle of a Houston grocery store (where we are going for Thanksgiving–Houston, not specifically the store). Hate that.
“Cancer Interv-hell”…what do you think?