Most Recent Scans

I had another round of scans last Wednesday. I got the results on Friday, and it was good news. The PET scan was clear of tumors. Interestingly enough, the scan picked up increased muscle activity along the right side of my body. The radiologist suspected the reason was altered biomechanics/gait from being an amputee. Well, hopefully any asymmetry will be a thing of a past with more rehab progress. I've been walking much better as of late, and I might move to a cane from one crutch this week.

Now for the lungs. In my last post about scan results, I talked about spots in my lungs, how one of them (the largest one) looked to have shrunk, and it's likely meaning (there was a tumor in my lungs because it responded to chemo). This time, I spoke with Dr. Wexler, another member of the pediatric sarcoma team, about the results -- Dr. Meyers, who is overseeing my treatment, was away -- and got a different perspective. With a lot of numbers.

First off, no new spots appeared, and the small spots remained unchanged. This is much is definitely good. Now for the large spot. The size of the large spot was said to be 4 mm in the first scan, and 2 mm in the next scan. On this scan, there was no measurement given, but the spot was marked as unchanged, though on the image itself it appeared more diffuse that before. Now, is this a tumor, or is it something else? Dr. Wexler said that what are definitively marked as tumors are spots at least 1 cm in size that have a dense, round appearance. One other thing to consider is measurement error. The CT scanner takes 5 mm slices. Thus, the size of spots that are any smaller are going to be harder to measure precisely.

So what does this mean? Really, there is no way to be truly sure if there is any cancer in my lungs or not. The only thing to do is continue treatment. The regimen I'm on assumes metastatic disease. I mentioned radiation to the lungs as a treatment option back in March. I have two more sets of scans, one in September and one in December. The decision on radiation will be made after the December scans. I'm hoping there's nothing in the lungs, but if there's anything, it's remained contained through almost 5 months of treatment, and should be treatable with radiation as Ewing's sarcoma is a radiosensitive cancer.

Now, since I've been in the habit of posting videos featuring my doctors, here's a Sloan-Kettering commercial featuring Dr. Wexler talking about one of his past patients. What comes through here is his storytelling, which has also been a feature of the times I've seen him. He has a knack for explaining things based on his past experiences, usually studies he's been involved with when I've seen him, which I have found very informative.