May 27, 2008

Once again I was hoping for all good news, expecting some minor problems, and fearing bad news. This is my weekly routine. Hope, Expectations, and Fear. I try my best to balance them, as we all do.

The CT Scan was taken last Thursday, 5/22 (same day that Isabelle Rohde was born). The results were reviewed on Tuesday (5/27) with Dr. Needles. Before he started his review, I mentioned that I'm sure the Pleural Effusions (fluid in the lining of the lung) had increased, as I have recently had constant pain in my left ribs, and an increasingly difficulty with shortness of breath and being able to take a deep breath. Seemed like the logical conclusion.

Well, guess what.... My Pleural Effusions have completely "resolved"! Gone! Nothing left but trace amounts of fluid! I had hoped that would be the case, but didn't expect it. Furthermore, that means I was completely wrong on my self-diagnosis! In addition to that surprise, I continue to have a number of small nodules (very small early tumors) in both lungs. This is not the cause of the breathing problems, and they have been stable since the last report in March. The same type of tumors reported in my liver last fall are no longer apparent. Good news, and bad news. Much like my expectations. On the other hand, the radiologist identified a possible tiny tumor in one of my left ribs, and he identified a cracked rib on the right side. I have no pain on the right side, and the left side pain is much higher in my rib cage than the reported 'nodule'. This is confusing and frustrating. Another bit of good news is that the lymph nodes on my abdomen are all stable, and there are no new problems there.

So I have these current issues - Left rib cage pain, shortness of breath, frequent nausea, and extreme fatigue. (As you can imagine, these put a big crimp in my golfing.) There is no explanation for these problems unless it is a reaction to the current cancer drug (Torisel). One of the know side effects of Torisel is Interstitial Lung Disease. In an attempt to identify what role the Torisel has in my breathing problem, we are going to back off the drug for a week or two. If it shows that my breathing improves, I will probably move on to the next treatment. That will be interferon-alpha, interleuken-2, and Avastin. This program has some harsh side effects, but have had some success as well. There are also other alternatives. One option is to go to the Univ. of Chicago and have a complete analysis done by the experts there. That may be happening sooner than later.

Your notes and your support fill me with encouragement and keep me focused on the "Hope" side of the spectrum. Thank you for your prayers, thoughts, and words of hope !!

D. J.