Monday, March 30, 2009

Making progress

I met with my oncologist today. My CT scan last Thursday showed improvements:
* The mass on my left adrenal gland is gone
* The pericardial effusion (fluid around my heart) is gone
* The tumor has shrunk some more

The shrinkage was not as much as I had hoped for. The measurements also seem to be dependent on which radiologist looks at them.

Tumor size February 11, 2009 (measured by Dr. O):
* 7.2cm x 3.8cm on the axial projection (side to side & front to back)
* 5 cm coronal measurement (top to bottom)

Tumor size February 11, 2009 (measured by Dr. D):
* 8cm x 4cm on the axial projection
* No coronal measurement given

Tumor size March 26, 2009 (measured by Dr. D):
* 6.7cm x 3cm on the axial projection
* 5.3cm coronal measurement

So just 1cm shrinkage in each axial direction, and no change in the coronal plane. Not nearly as encouraging as my first progress scan.

The type of lymphoma I have often leaves a mass of scar tissue even when all the cancer cells are killed - but 7cm would be a highly unusual amount of scar tissue. I was hoping for enough shrinkage we could possibly say the cancer cells were dead, and I'd only need two more chemo cycles (six total).

But since the tumor is still good-sized, I'll need more treatment after my sixth cycle. We'll do another CT scan: if the tumor has shrunk more, we'll do two more cycles (eight total) and evaluate from there. If it's the same size, we'll talk about other treatment options, probably radiation.

As disappointing as it is to be looking at months more of treatment, I feel so lucky I have a variety of effective treatment options available to me. Just thirty or forty years ago, I would have been dead within a year of diagnosis. So, hooray for effective chemotherapy, and on to cycle five.


Steve Hare said... don't know me, but I was diagnosed with Mantle Cell Lymphoma less than a month ago.

I was originally presented with two treatment options: 1. R-CHOP, 2. HyperCVAD.

Through the National Cancer Institute I learned of EPOCH-R and the trials they had done with EPOCH-R on my disease (can I call it mine?).

Anyway, I Google'd EPOCH-R and found your blog and wanted to let you know it has been helpful for me to read about someone else undergoing the same treatment.

I learned today that my doctor has decided to use EPOCH-R and I'll begin on Monday, April 6, 2009.

I also have been keeping a journal, but mine is through The support I've received from family and friends has been overwhelming. I hope you are in a similar situation with your blog.

Feel free to visit, I'll be updating my journal throughout my treatment (I already had started the FCR regimen, which I complete the first round tomorrow, March 31).

Thanks for your updates...again, they have been very helpful.

Jennifer @ Conversion Diary said...

What a great way to look at it. Thanks for keeping us posted.

Jen said...

I admire your positive attitude! I hope those home improvements are giving you positive distraction.