Monday, September 22, 2008 6:46 PM, CDT

Hi Guys,
I met with Dr. Uy today to discuss the CT scan I had last week (yes the same one that I discussed with Dr. Walsh). There was a lot going on today in the meeting so I’m going to try like Heck to make this understandable and hope that I don’t bore you to tears in the process!
The meeting started with Dr. Uy telling me that he’d like to do a biopsy. He told me the exact same thing that Dr. Walsh did—that there are more of these small bumps on my lungs than there was in August. He said they’re all very tiny and told me to imagine that I have freckles on my lungs. Dr Uy reiterated what a weird case mine has been right from the very start.
Dr. Uy explained that in terms of probability, there is a great likelihood that these freckles (I like freckles better than nodules!) are cancer. However, he would like to know for sure. He acknowledged that the lymph nodes in the mediastinum are slightly larger but not impressively so. His opinion differed from Dr. Walsh’s in that Dr Uy feels my lymph nodes would be slightly swollen if I had some sort of infection in my lungs. Dr Walsh, on the other hand, felt that the swollen lymph nodes were a slam dunk confirmation that the freckles are cancer.
He noted that even if these freckles are cancer, my lungs look a lot better than they did in January of 2007. Dr. Uy again said it would be rare if these freckles are cancer because when cancer comes back it usually behaves the same way it did the first time.
Let me rephrase that: Instead of it being rare if it’s cancer, I think what I mean to say is it would be a rare way for a cancer to behave.
It makes me laugh how unusual my case is and I find myself wondering how many rare cases like mine these guys see in any given year.
However, Dr. Uy added that my cancer has not been usual from the start. He told me that although he doesn’t see as much colon cancer as an Oncologist (and then I joked and said, and probably not as much as a GI surgeon—I mean the lungs are a definite site for colon cancer metastasis but instinctively you would think a thoracic surgeon doesn’t see much colon cancer based on basic anatomy), mine has not acted the same as the colon cancer he has seen. Based on what I looked like in January of 2007, Dr. Uy guessed that if my cancer acted the way it should, I would be dead by now.
Ok, statements like that make you sit up and look at the day a little differently!!!! J
At some point during the meeting, it became apparent that Dr. Uy had not yet spoken with Dr. Walsh. When I told Dr. Uy that Dr. Walsh doesn’t want to do the biopsy but instead would like to move forward with chemo, he seemed was surprised.
Dr Uy immediately got Dr. Walsh on the phone and the two spoke for a few minutes. Dr. Uy told us that Dr. Walsh isn’t usually as urgent as he was with his recommendation that I go immediately on chemo and skip the VATS. Apparently, Dr. Walsh is usually more flexible. And I remember when we met with Dr. Walsh in August and he referred me back to Dr. Uy, Dr Walsh said that he would defer to what Dr. Uy wants.
Things have changed.
Dr. Uy visibly wrestled with his recommendation after speaking with Dr. Walsh. I’m not entirely convinced that Dr. Uy thinks it’s cancer. Yes, he’s stated that it probably IS cancer. But I don’t think he’s sure. Plus, he’s a surgeon and would like to get in there and biopsy my lung and know for sure.
Here is the difficulty: If I have the VATS next week, I need to recover for 2-4 weeks before receiving chemo. My lungs need the chance to heal before pumping me full of chemo. That puts off treatment for another 3-5 weeks.
I think, and this is only my opinion, that Dr. Uy deferred to Dr. Walsh and chose the lesser of two evils. As I stated above, he visibly wrestled with his decision. He thought long and hard before he recommended I go with the chemo.
If I go on the chemo next week, I will have a CT scan in another 6-9 weeks. If my freckles have not improved, then Dr. Uy wants to do a biopsy.
I think Dr. Uy would rather let an infection or some other sort of lung disease go untreated for another 7-9 weeks rather than let cancer go untreated for another 3-5 weeks.
Does that make sense????? I hope so.
In a nutshell: I’ll be starting my new chemo regimen next Wednesday and I’ll have a CT scan at some point in November/December.
What do I think???????? Who the heck knows? I’m also skeptical that these freckles are cancer. Is it wishful thinking on my part? Maybe. However, even as sick as I was and as full of disease as I was back in January of 2007, I never FELT sick. Not even a little bit. Remember all I had was an annoying cough. That’s it. I was so damn full of disease and didn’t feel sick at all.
I feel a little sick now. My back and my legs ache the same way they do when I have a sinus infection. I have a cough right now like I did in January of 2007. Well, it’s not as bad as it was back then. But I do have a cough. However, all of those things go away when I take Motrin which I find to be odd.
When I told Dr. Uy about this he felt that it’s a good thing that my symptoms go away with Motrin because (A) It might mean my freckles aren’t cancer but some sort of infection and (B) if my freckles are cancerous then it’s not the cancer that is making me cough but instead inflammation in my lungs. And why would lung inflammation ever be a good thing???? Apparently if my lungs are inflamed and I have cancer, then my immune system is working like Heck to get rid of the cancer. In any event, Dr. Uy was very happy that my symptoms go away with Motrin.
However, here we are again: Scratching our heads and wondering what the heck is going on inside of me and wondering what the new course of treatment will do for me. We’re choosing a course of action only to be wary of its outcome.
Again, I will ask if anyone has a crystal ball or some sort of clairvoyant abilities. J At this point, I don’t care if it’s a crazy aunt of yours that can read tea leaves, do some Tarot cards, dust off an old Ouija board—anything!!!
I’m kidding of course—kind of.
I will start on Wednesday, October 1 and will be taking Irinotecan and Cetuximab on a weekly basis. Dr. Walsh made it seem like my side effects will be no big deal. I know the Irinotecan can cause some serious lower GI issues and the Cetuximab can cause an acne like rash. I’m going to try to get in touch with my nurse, Faith, before the treatment starts so I can get the straight story.
I guess there is an increased risk I might lose my hair, which I’m extremely nervous about. Dr. Walsh seems to think that I won’t but I’m going to worry about it nonetheless.
So I march onward in this battle and put my trust and faith in my doctors. I’m going to enjoy this next week and half off chemo and brace myself for the new drugs and the new side effects.
As happy as I am that I won’t have my fanny pack and I won’t have the neuropathy, I’m wondering if the devil I know is better than the devil I don’t know. I’m nervous about the new drugs because I was so familiar with the old ones.
If these new drugs don’t work, there is nothing else to give me. They’ll find an experimental drug to put me on but there are no other tried and true drugs for colon cancer. So let’s hope these work!!!!
I’ll keep you all updated!
Love,
Kim