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don m update


Don M

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I had a follow-up appointment yesterday with a pulmonologist at Swedish Cancer Center. The lab report showed no infection or tumor cells. If there were an infection, it would be the cause of inflammation. The bronchoscopy is pretty much inconclusive. I forgot to get a copy of the report. The doc told me that there is no need to go into treatment immediately. He said that the radiation oncologist said that I could not have any more IGRT at the site, because it would fry my lung. If there is going to be local treatment, it will be cyberknife. I am going to wait another 2 months and then do another PET/CT scan. That will make it 3 months since my last scan in mid December. If there still appears to be a viable tumor, I will see an interventional pulmonologist. By then, he should have a new technology deployed, called “SuperDimension Bronchus”. It uses GPS technology with a magnet at the tip of the bronchoscope, so that the device can be navigated anywhere in the bronchus tree. At the present, a bronchoscopy is limited to the upper one third of the lung, and one could easily take a wrong turn and get lost (not find the tumor). So, with this technology, the interventional pulmonologist will be able to do all the twisty turns needed to find my tumor and get a tissue sample and insert fiducials for cyberknife.

The fiducial-less technology is not yet deployed. I think it is more restrictive anyway. I think it is effective for tumors close to the surface and mine is deep in the lung. My tumor probably meets the minimum size for fiducial-less technology, which is 1.5 cm. I read that the fiducial-less technology is accurate plus or minus 1.5mm while the fiducial technology is accurate to sub millimeter. So using fiducials is a bit more accurate. I suppose that does not make much difference in the lung though. So, anyway, if they have the SuperDimension Bronhus up and running 2 months from now, and it appears that the glow did not go away, I would at least try to get another biopsy with the GPS equipment.

One thing that bothers me is that if the glow is a tumor, and it tripled in size within 3 months, why is there no hurry? I did not ask the pulmonologist about this at the consultation. I am going to have a phone consultation with the radiation oncologist and ask him that question this Thursday.

They are very reluctant to poke holes in my one and only lung, whether for a needle biopsy or for fiducial placement. Now it looks like they will have a solution in a few months so that I can get a reliable biopsy and fidcuial placement if needed without a risk of a pneumothorax.

I don’t mind waiting. I think it is a pretty remote possibility that it is an active tumor. I would rather wait than get fried, poisoned or have my lung go flat.

Thanks for your suport everyone.

Don M

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Hi Don,

I was just going to post to you for an update, but I checked first and saw you updated.

I will continue to send prayers and pray for good results when you have your PET/CT in a couple of months.

Hang in there, my friend. You have been through so much and I admire your courage.

Maryanne :wink:

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