Monday, April 20, 2009

Conversation with my Colleague

As I posted a few days ago, I'm not entirely convinced that those lung spots on the CT are cancer. I chatted about it today with my colleague, who has a Ph.D. in genetics (I think) and whose brother is an MD (I think). S. has been my source for medical research reports - he'll read them and then explain the nitty gritty details for me. (S., I know you read the blog - please correct me!)

First, I asked S. about what he knew about the relationship between tumor markers and metastases, particularly in the lungs. I asked how likely it would be that I would continue to have low tumor markers and still have a metastases. In the end, from what I understand from him, it would be highly unlikely to have a lung metastases with my low tumor markers.

Second, I mentioned how unconcerned Dr. K seemed to be when we talked on the phone last week. He had the CT report for six days before calling me, which suggests that there was no urgency. He said that he just wanted to stay the course in case of my treatment regimen (Tykerb). If it grows in the next three months, then we consider Xeloda. But he said "if". He also told me to go ahead and keep with my long-term planning with work (i.e., years). He gave me the impression that he didn't expect the spots to grow at all. As I reflect back on the conversation, Dr. K seemed really unconcerned.

Third, I mentioned to my colleague that I had a 1cm spot and 2 4mm spots. Now, my first bout with cancer, I had a 2-2.5cm tumor that the doctors said had been growing for 8-10 years (slow-growing). This time, I had tendrils that extended out 5cm and then had spread to my skin and I had bb-sized ones in my bone marrow, which Dr. K estimated had been there for "months". This cancer was "medium growing". My point is that how did a 1cm lesion grow so quickly in 8 months? My cancer wasn't fast growing - those spots weren't on the CT scan in August. If my latest cancer was "medium growing", I just have this impression that it wouldn't be so big so quickly.

My colleague and I then talked about how perhaps I picked up some kind of infection that's affected my lungs while I was on the airplane to Norway, which would show up as spots on a CT scan. He also said that the spots could be caused by many different things.

Then, about 30 minutes later as I sat in my office preparing for class, S. came into my office and asked me if the CT scan found anything in the liver. When I replied that it didn't, he said that, in general, most breast cancers progress to the skin or the bones first, then the liver, then the lungs, then the spine, then the brain. It doesn't very often happen that it would go to the lungs before the liver. So, again, it's highly unlikely, since my liver is clear, that those spots are cancer on my lungs.

So, all in all, a good conversation about the likelihood that there is cancer in the lungs - not very likely at all. It made me feel better. I was feeling a bit down this morning as I walked to work - I didn't really want to be at work both because it was gorgeous out and because I'm burnt-out still from teaching; I got to thinking about how long it was going to seem before my next CT scan (and having to live with uncertainty); and I still had to grade some papers (the worst part of my job). It was a Monday, for sure. The conversation with S. perked me up. Thanks!


MisAnthropology said...

What's he say about the TB idea?

Dee said...

Hi Mary,
He said that that might definitely be an idea to look into. I am still considering getting that skin test, but he thought that perhaps I have certainly been exposed. I may not have active TB, but perhaps it's latent.

Your comment may be just what I need to look into getting that test done.