Scan results are in ... good news and bad news

We went in today to get the results of the two scans I had on Friday. The results were mixed. First, the good news ... the pituitary tumor has markedly decreased in size in the 3 1/2 weeks since the last scan. It has shrunk from 1.3 x 1.2 x 1.2 cm down to .7 x .9 x .4 cm! This means that I won't be having surgery on my pituitary, at least not right now. I had resigned myself to the idea that surgery was my best option for treating the tumor, but it appears that surgery is no longer necessary at this time. We will continue to monitor the tumor with MRI and if it should start to grow again, the surgery option will be revisited. I am relieved to be able to put it off for now, though!

Now, the bad news ... the liver tumor has grown significantly over the last three months, and a new 1.8 cm tumor has appeared as well. The large tumor has grown from 4.1 x 4.4 cm to 4.8 x 6.9 cm. Yikes, it is getting big! Too big, according to my oncologist, for radiofrequency ablation and for surgical resection. There was some good news in the report, however. They are now saying that one subcentimeter tumor appears to be a hemangioma (a benign tumor) and that the several small lesions now appear to be cysts. That means that of the two dozen lesions that were on my liver when the mets were diagnosed in Dec. 2006, only two are now considered metastatic tumors.

My oncologist said that while the tumor is large, it is only taking up 5-10% of my liver. The liver doesn't start to lose it's ability to function until 70% is overtaken by tumor, so I am still a long way off from that. My liver function tests all continue to be normal, and I am feeling fine. On Friday, I will have my first whole body PET scan, which uses radioactive glucose to pinpoint the cancer throughout the body. Cancer cells eat up glucose much more rapidly than normal cells, and the PET scanner measures the "uptake" of the radioactive glucose and highlights the hot spots, presumably the areas where there is cancer. My doctor thinks there is a chance the large tumor on my liver could be partly necrotic (dead tissue), and the PET scan can show how active the tumor is. We will meet with my oncologist on Monday to go over the results of the PET scan.

Alan and I were talking today about how, a year ago, news of a 7 cm tumor on my liver would have really freaked us out! But, while I am not happy to hear that the chemo is not working on this tumor, I am really not too worried about it at this point. There are still several options available to treat it, and like I said above, my liver is functioning normally and I'm feeling fine. It's funny how much my (our) perspective has changed over the last year. I used to be such a pessimist, but now I try to look for the positive side to things and count my blessings where I can find them. Life is much less stressful this way :)

Kid Pics and Sarah Update - 28 March

Sam and Elizabeth during our visit to the New Orleans wildlife preserve. We got to see & feed giraffes, antelope, camels and long-horn cows.
Mmmm... chocolate Easter bunny is the best!
Sam looks very happy about this birthday gift! I can almost hear him say "cool!"
Ben's first cello recital! He played Twinkle Twinkle Little Star with his first-year group.

Just before our New Orleans trip, we talked to quite a few doctors to discuss Sarah's pituitary growth: her neurosurgeon & radio-onc at Univ. of Chicago, her oncologist and a radio-onc doctor at Northwest Community hospital where she received radiation treatment. After learning that all of them recommended conventional surgery vs. stereotactic radio-surgery (when it is required due to continued growth or symptoms), Sarah has come around to this point of view now.

The plan is to get another brain MRI and also a liver MRI to see how the Taxol-Carboplatin is working and then go from there. She gets the MRIs tomorrow (Friday) and we should have results on Monday when she goes in for Taxol-Carbo treatment #5. If her liver tumor is larger (no please no), we may very well end up switching her to a different chemo -- so, Monday is a bit of an unknown. If her pituitary growth has growth some more, then she may also end up getting the pituitary surgery as soon as we can schedule it. Otherwise, she'll likely wait until there is either significant growth or there are further symptoms (not all the docs agree that her headache two weeks ago was caused by the pituitary growth) . We don't know what else could have caused it, but it has not come back even after coming off the Decadron. It is still possible that the growth is a benign "adenoma" - in that case the surgery could be all that is needed to reduce the growth's size with no follow-on treatment required except potentially hormone replacement drugs (if any pituitary function is lost)

We're hoping that Taxol-Carbo has done some good for her liver mets. That will be answered Monday, and we know that these things are very unpredictable, so we aren't going in with any expectations one way or the other.

Ski Trip and Update

We went on a ski trip with friends this weekend (to Wisconsin) and had a blast! Sarah and I hadn't been skiing for eight years and of course it was the first time for the boys. They learned quickly and Ben even went down some black slopes -- although that really scared us since he just went as fast as he could, without turning until the bottom. Sam liked skiing so much that he was inconsolable when I told him it was time to go home. :) But, we are all exhausted and I'm sure our muscles will be sore for days...
Sarah gets Taxol-Carbo treatment #4 tomorrow. It's been a tough week in Cancerland: Sarah developed a headache last Tuesday that pretty much stopped her in her tracks. At first we were worried that she had a brain hemorrhage since we'd been warned about it (related to the pituitary met) so she went in to get it checked. A rapid CT showed it wasn't a hemorrhage but she also got results from a more detailed brain MRI which was done last Monday and it showed that the pituitary met had grown slightly (not good - we were hoping to see size reduction due to the chemo). Since there is not much room near the pituitary gland, the docs believe that this small size increase is probably causing the headaches. She's now taking the steroid Decadron to control any swelling/inflammation and it made the headaches go away for now, but we've got to decide what to do about the pituitary met now. Options are radiation surgery or conventional surgery. We'll be talking to the neurosurgeon at University of Chicago cancer center over the next week to discuss it.
It feels like we're back in limbo again, unfortunately a familiar feeling now: we hope that Taxol-Carbo is pushing back Sarah's cancer, but all we know today is that her tumor markers are not down yet and her brain met didn't get smaller. We won't really know how effective this stuff is until we get a liver MRI done which is planned for around 2.5 weeks from now. That's a long wait, but these days Sarah and I both try to avoid worrying too much until we actually have test results or other new information.