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stupid cancer

Don M

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I have been coughing a lot and having a hard time breathing in the last month or so. I thought for sure I had pneumonitis, but I got an x-ray today and it turns out I have pneumonia. It is the “walking pneumonia” variety. I don’t have a fever or chills. I got some medication for it and will start taking it tomorrow. It is a type of pneumonia that is associated with having lung cancer. They call it “post obstructive pneumonia”. I think the obstructive part is the tumor getting in the way of free movement of fluids through the lung but I am not sure. I will have to read up on it or ask the doc tomorrow. They want me to have a ct scan tomorrow and examine me at the Seattle office. The ct scan will give them a bit more information that the x-ray was vague on. It will also give them some good detail about the state of my cancer.

I had my PET/CT scan on 8-31. The scan showed a new hypermetabolic nodule, about 1 cm in diameter, near the main tumor. It is probably a new tumor. If it is cancer, it is the first new disease in 2 years, so that makes it likely that it is a new primary rather than a spread. The radiologist noted a moderate increase in size of the big tumor. He did not know that I had the tumor treated with cyberknife at a different facility, so he read the apparent increase in size as tumor progression. I have not asked my radiation oncologist about it yet, but I am sure that she would say that the apparent increase in size is caused by the application of part of the tumor dose on healthy tissue around the tumor. The image shows a corona on the healthy tissue around the tumor, which is where I had some of the radiation, and so it would show up as an inflammation and be hypermetabolic in the scan and make the tumor look bigger. I feel pretty confident right now that I don’t clearly have progression in the big tumor. I am disappointed that I have what is probably a new tumor.

So tomorrow I am going to Seattle to take care of my pneumonia issue. On 9-17, I go back to Seattle to discuss my scan and future treatment options with my radiation oncologist and I will also consult with a medical oncologist on the same day. My regular radiation oncologist is on vacation now. I am seeing a new guy tomorrow about my pneumonia. I am very happy that the pneumonia is going to be resolved. Soon I will be able to go through the day without coughing and I will save a bundle on cough drops.

I already have a plan in mind that I will run by the docs. I am thinking of doing nothing for the next 3 months and then rescan. If the big tumor shows some favorable changes, then the treatment is working. Usually 3 months out from a radiation treatment is too soon to tell if it is working or not. It takes time for the tumor to shrink and just 3 months out, the inflammation makes the scan ambiguous. By the time 6 months has gone by, the treatment-induced inflammation should be gone and you can see the true scope of the tumor.

I think the cyberknife center will soon have or may already have a technology up and running whereby fiducials are not necessary for the robot to see the tumor during treatment. Fiducial placement is the riskiest part of the cyberknife therapy because they have to jam these little metal markers in around the tumor so that the robot can track the tumor. If I can avoid that, I will. The risk is my one lung going flat. One of the requirements for the fiducial-less technology is that the tumor be at least 1.5 cm. I think my new tumor is now less than that and they may want to let it get bigger so that they can use the fiducial-less technology. So I may wait for 3 months to see what the little tumor is doing too.

If the big tumor shows progression in 3 months, then I will do chemo or some form of targeted drug therapy, regardless of what the new nodule is doing. If the new nodule shows no change in 3 months, then it may not be cancer and I will continue to monitor it for changes. If it shows growth, and the big tumor is stable or shrinks, then I will get the little tumor zapped. I don’t think I can have cyberknife on the little tumor if I am doing chemo.

What I hope happens is that in 3 months, the big tumor will have shrunk and the new nodule will show no change.

I really doubt that they will advise me to do chemo at this time until it is clear what the big tumor is up to and/or I am done with the pneumonia. After the 17th, I will know for sure what happens next.

Stupid cancer.


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I'm sorry your having to deal with this pneumonia crud. I sure hope you'll be feeling better soon.

I'm bumming over the nodule news. Yes, cancer is STUPID, and it sucks!

I'm going with your good thoughts that your "big" tumor will have shrunk WAY DOWN to nothing, and that your nodule will just sit there for a short time and go away as fast as it came. Damn nodules!!!!

Keeping you in my prayers. Sending some positive vibes your way.

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Darn Don, I am really sorry for all this nonsense!

At least it turned out to be Pnemonia (sp) which is treatable.

As usual you are always in my prayers and I pray that your scans will show a significant improvement.

You just can't seem to catch a break which you most certainly deserve. But as usual I love your attitude and I am right in your corner cheering you on all the way!

Prayers sent my friend,


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Sorry for the pneumonia but now you

will start your medivation for it

and I'll pray that it goes away.

You have your plan all ready for

the consultation and giving time

for the C/K to do all the healing

possible may be the best.

Will keep the prayers going till the

next scan September 17th.



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John has that obstructive thing going too. His cough is terrible. The onc gave him codeine pills to try and they seem to help him at night so he can sleep. He is using an inhaler, tessalon perles, cough syrup, and the pills. It sounds like you have a good plan in place, let us know how everything goes.


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I'm so sorry you have to deal with pneumonia now too as well as the new tumor. I think it's a good idea for you to hold off for a few months with chemo. It's important that you control these treatments, after all, it's your body. Prayers for you for strength.

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You have been in my thoughts and I am sorry to find out you are having such a rough time. "Stupid Cancer"!!!!!!

One thing we know about you is that you will think this thing out, research it, ask questions and get involved in the decision making process. Know that you have my prayers that everything goes well from cough to tumors. Saying lots of prayers for shrinkage and disappearage... :wink: Take care Don and God Bless.


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Well Don.....words escape me for a couple of reasons. First of all...........cancer to deal with AGAIN!!!! Cancer is much more than stupid ~ it is downright sneaky :roll: and evil :twisted: . But words escape me also for the strength with which you persevere on. I have told you before on more than one occasion, that you are truly and awesome man. You use reason and all available resources to continue along this journey we call the lung cancer journey.

May your research be fruitful, may your doctors be proactive, and may your treatment bring about a much sought after resolution.

Much luck to you, Don, along with prayers and everything else I can muster up in this aresenal.


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Don - So sorry to hear this stupid cancer is causing issues again. Sounds like you have a solid plan. The meds will help your cough but my mom just had walking pnemonia earlier this summer and it took her awhile to get rid of the fatigue (2 months?). I warn you about this so that you don't think it is cancer kicking your butt, it is your body trying to get over the pnemonia!

Hang in there! Karen

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STUPID #@$%*&! CANCER INDEED!! But one SMART Don!!! Your calm, intelligent approach never ceases to amaze me, Don! I just KNOW it will serve you well in this latest bend in your journey...

I have SO much anger at this damned disease right now, that I can't seem to find any words that I wouldn't have to edit :evil: If my words could be a cyberknife they would wipe that new nodule away, and go to town on the "big kahuna" as well. :wink: Guess I'll have to send PLENTY of positive vibes, and prayers your way instead.

Hang in there, Don, and feel better soon!

Yours in HOPE!!


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I totally agree! Stupid Cancer! Simple but so true. I am happy to hear that you have a plan in mind that you feel comfortable with. That is one of the biggest issues. Figuring out what you want to do and then going for it. Hoping the primary tumor shrinks and the little one just goes away. Hope the Pneumonia goes away soon too.

Take Care,


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