First Diagnostic Scans Done!

We’re through the first set of diagnostic tests to look for any spreading of the tumor and no evidence was found. This was a slightly different session at the hospital because Tim had to go through the “normal” admitting process for this set of CT scans. Since all of the early initial work was completed, we have been fortunate enough to skip all the paperwork to be admitted to the hospital. Even though these tests were outpatient ones, we had to do that again, but we’re old pros at it now anyway. Have your insurance card available because they have to take the 21st copy of it “for the files”. Oh well.

This test was a pair of CT scans of the chest with contrast both oral and injected. Injected contrast is not a feature of these tests that Tim looks forward to. He was, and so were we, nervous about these tests because they were the first taken since treatment started. Was it possible that the treatment had not been working? Could there be tumors developing in the lungs? These were possibilities to be considered. Even though the oncologist told us outright that he expected no disease to show up, there is still that concern. So nerves were at a high level. Tim couldn’t keep the oral contrast medium down.

They mix the solution into a 7-up and he has to drink all 16 oz of it over a 20 minute period. This is after not eating or drinking since the previous night and on a nervous stomach. At least they didn’t make him start over and went ahead with the scans. The other contrast medium has to be introduced through an IV in the arm since the volume is 75 ml introduced over 30 seconds. The port-a-cath can’t handle that rate.

After the scans, the data is pretty much available right away and we were able to leaf through the CT slices in the oncologist’s office. A quick scan showed no issues and so that was a relief. Further review is always done by a radiologist of course, but this was really good news.

In the discussion about the treatment plan, we began to explore the variability of plans. These plans are really created over time by committee and are recommendations. The oncologist more or less looks up the type of cancer and voila, the plan is there. The two plans we talked about are for low and medium risk patients and what goes against logic is that the low risk protocol is more aggressive than the medium one. So we’re going to have a thorough review of the plan to determine if Tim has to go through all 16 cycles or if 12 might be just fine. There are also variations of administration of vincristine and dactinomycin.

The first 4 cycles are the same for all plans, even the clinical trial. So it’s really no problem that we are only now entertaining how to proceed from here. This was really good news that the number of cycles might be reduced while still being aggressive enough to be successful. We’ll have that consultation shortly. For now though, we are through the first diagnostic scans and Tim is doing great with no spreading of the tumor.

--bob