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It is back

Lady Salt

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We went today to the oncologist fully expecting to receive a positive outcome from the CT scan and some answers related to pain / weight loss. What we got was not what we wanted and needed to hear.

I will transcribe here the report, because I can't understand most of it, but basically what the doctor said was that the CT scan shows something is in there. She mentioned the possibility that it might be scar tissue from the radiation, but that we must consider the possibility of the cancer being back. I have the report with me and here is the bulk of it:

"There are increasing masses in the right upper lung with focal posterior rib destruction of the 3rd right rib posteriorly and T3 right transverse process. The 4th rib is also thought to be affected along its medial margin. There is sof tissue mass effect posterior to the trachea. There is soft tissue mass identified posterior to the vena cava

A small area of atelectasis is seen in hte lingula. No lung metastases are identified.

There are precarinal aortopulmonary window lymph nodes which have enlarged slightly. Slight density is identified in the right hilum, but no definite lymphadenopathy is seen. No left hilar adenopathy is identified"

Can anyone help us understand all that lingo please? We are extremely worried and scared, mostly because we cant understand what is going on. In February he had a CT scan andeverything appeared normal... and now this? Can it really be scar tissue from a radiation treatment that took place in December last year? if so, why didn't it show in the past CT scan?

David's pain is still really bad. The doctor mentioned that if it is confirmed cancer, more than likely he will receive the "traditional" treatment of Tarceva or Taxoterre vs clinical trials because of the weight issue.

If anyone can help us understand the report I would be so very grateful... things seem to loose their "fear power" when we understand them better.

David will have a complete body bone scan on Friday along with blood tests. Next week we will meet with the surgeon and evaluate the possibility of a biopsy.

In the meantime, we wait, we worry, we suffer.

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The best person to answer your questions is your oncologist. She has them there and can compare them to previous ones. The report you quoted talked about an increase, so they must be comparing them to a previous scan. When the previous scan was taken would be important to know. I would get hold of your oncologist for clarification. If you still have doubt you may want to consider a second opinion. It could be scar tissue. Having Tarceva instead of a clinical trial may not be so bad. It could be better than a clinical trial. My choice would be Tarceva over a clinical trial, but I am a little partial.

Stay positive, :)


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I called today the doctor that directed David's radiation treatment last year. He was extremely supportive and immediately got us an opening to see him tomorrow first thing in the morning (despite the fact that he was fully booked.. bless him!). We just picked up from the Hospital the CD with the actual scan plus the report to take to him when we go.

When we saw the oncologist yesterday we were so totally unprepared for the news that I think it took our minds a few hours to start working again... I didn't ask the oncologist any questions, didn't think to ask any questions.. actually I don't think I even spoke to her after she told us.. and I feel terrible because asking questions and finding answers is my responsibility. David is too weak and sometimes too confused to be worrying about that.

Hopefully my head will be in fully working order tomorrow and I will get as much information as I can from the doctor at Sunnybrook.

Thank you all so very much for your support and your advice. It truly means a lot to me!

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I think we all need time to digest what is told to us. You shouldn't feel bad, you are human. I think I am that way at most of my mom's appointments. I always think of questions the next day. My mom's Dr gave me his e-mail because he has learned I usually need time to really take in all he says.

You are am amazing care giver. Ask questions and keep asking until you understand. SOmetimes Dr.'s just don't talk english!!!

My prayers are with you both, stay strong,


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By now, you've probably had the opportunity to go over the situation with your radiation oncologist. There's a lot of jargon in the part you covered, but the important points are that it unfortunately sounds like there is some progression of what looks very much like cancer in a couple of the vertebrae, and also some increased "soft tissue", which means it looks like cancer tumor tissue, in areas toward the middle/back of the chest. Radiation would be a serious consideration if that area hasn't already received radiation, as we don't like viable cancer to encroach on the spinal cord, so we tend to be fairly aggressive when tumor is in the vertebrae.

Good luck, and I'm very sorry about the unfortunate findings on the scan. I hope you're embarking on a plan, and that it will help.

-Dr. West

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