Finally done with leg ulcer healing time, which means it's back to Sutent time. Last Thursday I was officially discharged from wound care and took my first capsule of cycle 9. Since I had been off treatment since late July, Dr. Rini wanted me to be scanned again so that the next scans would be compared to now, rather than where I was two months ago. The rationale is that in the last two months we expected progression of the cancer. I was a bit nervous about what they would find, though I am no longer nervous at all about the scans themselves. It's interesting to learn that what I once thought I couldn't tolerate, is now just a minor event in my life. I had my first MRI scan in 2005 when they still didn't know what lurked in my kidney. It was brief, only 10-20 minutes or so, because of my pregnancy at the time. But to me, it was an eternity and I felt very trapped in the tube. Once it was decided in 2009 that I should have MRI scans of my abdomen and pelvis rather than CT scans, I had mixed feelings. I still felt anxious about being confined to that narrow, loud tube, anxious enough that Dr. Rini gave me a prescription for Xanax to take prior to scan appointments. On the flip side, no more CTs below the chest means I no longer have to drink the oh so flavorful and delightfully slimy Redicat contrast drink. I am now able to go into the MRI without drug help and for the first time last week, was relaxed almost to the point of sleep while in the tube. I can't in fact sleep in there because I have to hold my breath during several images. Now, the only rough patch in the scan procedure is getting the IV inserted; my veins are too shy for the average nurse or tech to find easily.
Back to last week's scans. The results were as follows:
CT of chest - detail of lungs
RESPIRATORY SYSTEM: Multiple bilateral pulmonary nodules, many of which have decreased in size. For example, 2-mm nodule in the entry site of the right upper lobe (SP 145) previously measured 4 mm. Additional interval decrease of 8-mm poorly marginated right lower lobe nodular opacity (SP 50), previously measuring 10 mm. No new pulmonary nodule, parenchymal consolidation or foci of cavitation.
In plain text - I have multiple little dots in my lungs. Many have shrunk, including one going from 4mm to 2mm and one from 10mm to 8mm. No new dots seen. Bottom line:
IMPRESSION:1. IMPROVING BILATERAL PULMONARY NODULES, REPRESENTING FAVORABLE RESPONSE TO THERAPY.2. NO INTRATHORACIC ADENOPATHY SINCE 25 JULY 11.
OK, that is great news, and surprising given my time off treatment.
My abdominal and pelvic MRIs are read and reported together. Here are the Cliff's notes:
Abdomen:Previously identified ring enhancing lesion in hepatic segment VIII (series 21, image 36) is stable in size measuring 1.2 x 0.9 cm, but demonstrates increased central enhancement. Additionally, there is a new hyperenhancing lesion in hepatic segment VI, which measures 1.1 x 1.1 cm (series 21, image 70).
This is a good news/bad news scenario. Bad news - there is a new spot in my liver, joining the one that remains. In truth, this could be a lot worse, considering that I had four of these spots prior to starting Sutent. Good news - I'm told that the "increased central enhancement" of that tumor can mean that it is dying off.
This is the spinal thing that they saw earlier this year. I am having a lumbar MRI and seeing the neurosurgeon next week for a 3 month follow up to hopefully confirm that it is just a hemangioma.
Pelvis:The previously identified pelvic omental nodule is stable in size, measuring 1.7 x 1.4 cm (series 8, image 46). There is no new pelvic mass oradenopathy.
So, the one spot in the pelvis is still there, still stable, and most importantly, has no tumor friends that have joined it.
Wow. This was better news than I could have hoped for. Well, in truth, I could hope that everything just disappeared since July, but I know better than to hang my hat on that hope. Clearly though, Sutent was still kicking some cancer ass even while I spent my summer letting my leg heal, and getting very sluggish as a result. I need exercise!
So that is the latest medical update. Like I said in the title, I'm still kickin'...