Not Entirely Reliable

Today was the fifth chemo and the CAT scan results.  We had the results before we went down to Bellingham to see the doc today because that is the new wonder of electronic records.  Results and reports go on line and they give you a copy of them if you ask.  We get them from the clinic staff up here in Point Roberts.  My prior experience with all this sort of thing was that they wouldn't dream of telling you anything at all until some qualified person had sat down with you in a room and after a little talk, everything is illuminated.

So, we got the CAT scan results yesterday.  We both read them and re-read them and said to ourselves, it is not clear that everything is illuminated.  Perhaps the doc will put this all in some perspective that will enlighten us.  So, today when we saw him, we found that, not surprisingly, everything is not exactly illuminated because, even now, it is not entirely clear what the information we have means.

The CAT scan showed the known four tumors in the liver all reduced somewhat or moderately in size, but a new tumor appearing that was not identified in the initial scan.  No other new tumors were seen anywhere (not in the colon or the lungs, particularly, but not anywhere at all).  So, is this good news?  Or sort of good news?  Or not such good news?  Well, if one was hoping for an entire disappearance of all tumors, then it's not such good news.  (Sorry, Tom, no spontaneous and total remission.)

But, says the doc, the fact is that the tumors that continue to be there may not be 'viable tumor material.'  And the new tumor may not be new.  Because the first CAT scan was done five weeks before the first chemo, that tumor could have been happening during that five weeks and the chemo could have already reduced its size.  That is, if we had a baseline scan just before the chemo, then it would maybe tell us more.  But maybe not, because maybe it was there at the time of the first scan but it just didn't capture it.  And, the CEA keeps going down (last move was 30-25).  So the trend is right and the trend is good.  And there you have it.  Or maybe you don't.

This all does seem to me like a moving target, but I also remember that the first time we talked to the oncologist he said that the best indicator of how things are going is how Ed is feeling.  And, overall, Ed is feeling fine.  So, I think we just have to conclude that it's working.

And so we moved on to the infusion center where he had the fifth treatment.  By the time we got back home, around 6 pm or so, we were both exhausted.  So, says Ed, maybe it's Bellingham that is wearing us out.

The plan, then, is since it seems to be working and/(or?) since Ed tolerates the chemotherapy so well, it will continue on an every other week basis and he'll have another CAT scan in a couple of months, which scan will have a better baseline for an assessment.  But the scan may not be entirely reliable.  Nor the CEA reading, as far as that goes.  At least Ed can tell us how he's feeling with some considerable degree of authority.