The Oncologist and I - 1
I met with "The Oncologist" on Thursday. ARainBowCat went with me. It was my first day out driving since I came back from the hospital almost 2 weeks ago.
I must admit it was an interesting experience. The doctor is Timothy Murphy (of the Cancer Center of Colorado), and I will say he is a good doctor. He tries very hard to be honest and straightforward without being brusque, abrupt, or without feeling. It was interesting to have him bring my file (about 3" thick now) in and smile at me.
First, before we got to the immediate "cancer" questions, he asked about the hospital stay, how I felt, what was going on, why *I* thought I had been in the hospital, etc. I told him (too long to type here). He agreed that there was some cause for concern and that there was good reason for me to have been hospitalized. I asked the $64,000.00 question (that really "dates" me, doesn't it?)
He answered as follows: "Well, we took 12 MRIs and angles of your head and brain - you did NOT have a stroke. We found no evidence of cancer in your head or brain. We checked your EEG. It is normal, no evidence of permanent or long-term damage. We checked your heart, stomach, chest, neck, intestines, and back via CT and XRAY. We find no evidence of cancer. The Lumbar Puncture (aka Spinal Tap) shows no abnormal cells of any kind, a very slight variance with normal chemistry - easily explainable by your long-term back problems and a result of long-term diabetes. There is no evidence whatever of cancer in your body at any place or in any form. I think I can, heck I can, reliably state that you are in remission."
Wow! "What about the PET Scan?" I asked.
"You finished radiation at the end of December; it's too soon to do one. If we do, we will end up with false hot spots. I want to see you every 3 months for the next 2 years; we will do a PET/CT every 6 months during that time. After that I will want to see you every 6 months with a PET/CT once a year until 5 years are up. If we are still in the same position then, I will state that you are cured. Frankly, with what you went through, and what you did, I can tell you that STATISTICALLY you have 97+% chance that this cancer, or any similar cancer, will not recur. I can't guarantee that, but you have done remarkably well."
"Uh... what about my problems? My hands, my mind, my memory, the fact that I've lost 10lbs since I got out of the hospital?"
"Well, your chemistry is good - other than the diabetes, we see nothing out of the ordinary. Your heart, we did EKG, blood enzymes, XRays, is in excellent shape, as are your lungs. Your need for oxygen, except as a product of the apnea, eliminated - and your apnea has gotten better, you shouldn't need as much oxygen at night, and it should improve with time"
"But..."
"Did you expect everything to be back to normal by now?"
"Well, hell, yes! I was told 90-120 days and the "chem-head" should go away, and..."
"With what you had, four FULL doses of CHOP and Retuxin, we were saying 90-120 days before it's out of your system. Radiation continues to have an effect for 3-4 weeks after it's discontinued, and takes another 60-90 days before your system finishes reacting to it. Your last chemo was Halloween. Your last radiation was just before Christmas. Do you have ANY idea how well you're actually doing?"
"Uh, what?"
"Most people don't get past 3 doses of the chemo we gave you before they give up on it. They don't want to do radiation after it, and often wait too long between them. We normally will start reducing the chemo strength after dose 2, you went 4 full doses."
"I couldn't do 5, I thought it would kill me."
"It might have killed me"
"What?"
He said, "I couldn't give you another... I saw what you were going through..."
I must admit it was an interesting experience. The doctor is Timothy Murphy (of the Cancer Center of Colorado), and I will say he is a good doctor. He tries very hard to be honest and straightforward without being brusque, abrupt, or without feeling. It was interesting to have him bring my file (about 3" thick now) in and smile at me.
First, before we got to the immediate "cancer" questions, he asked about the hospital stay, how I felt, what was going on, why *I* thought I had been in the hospital, etc. I told him (too long to type here). He agreed that there was some cause for concern and that there was good reason for me to have been hospitalized. I asked the $64,000.00 question (that really "dates" me, doesn't it?)
He answered as follows: "Well, we took 12 MRIs and angles of your head and brain - you did NOT have a stroke. We found no evidence of cancer in your head or brain. We checked your EEG. It is normal, no evidence of permanent or long-term damage. We checked your heart, stomach, chest, neck, intestines, and back via CT and XRAY. We find no evidence of cancer. The Lumbar Puncture (aka Spinal Tap) shows no abnormal cells of any kind, a very slight variance with normal chemistry - easily explainable by your long-term back problems and a result of long-term diabetes. There is no evidence whatever of cancer in your body at any place or in any form. I think I can, heck I can, reliably state that you are in remission."
Wow! "What about the PET Scan?" I asked.
"You finished radiation at the end of December; it's too soon to do one. If we do, we will end up with false hot spots. I want to see you every 3 months for the next 2 years; we will do a PET/CT every 6 months during that time. After that I will want to see you every 6 months with a PET/CT once a year until 5 years are up. If we are still in the same position then, I will state that you are cured. Frankly, with what you went through, and what you did, I can tell you that STATISTICALLY you have 97+% chance that this cancer, or any similar cancer, will not recur. I can't guarantee that, but you have done remarkably well."
"Uh... what about my problems? My hands, my mind, my memory, the fact that I've lost 10lbs since I got out of the hospital?"
"Well, your chemistry is good - other than the diabetes, we see nothing out of the ordinary. Your heart, we did EKG, blood enzymes, XRays, is in excellent shape, as are your lungs. Your need for oxygen, except as a product of the apnea, eliminated - and your apnea has gotten better, you shouldn't need as much oxygen at night, and it should improve with time"
"But..."
"Did you expect everything to be back to normal by now?"
"Well, hell, yes! I was told 90-120 days and the "chem-head" should go away, and..."
"With what you had, four FULL doses of CHOP and Retuxin, we were saying 90-120 days before it's out of your system. Radiation continues to have an effect for 3-4 weeks after it's discontinued, and takes another 60-90 days before your system finishes reacting to it. Your last chemo was Halloween. Your last radiation was just before Christmas. Do you have ANY idea how well you're actually doing?"
"Uh, what?"
"Most people don't get past 3 doses of the chemo we gave you before they give up on it. They don't want to do radiation after it, and often wait too long between them. We normally will start reducing the chemo strength after dose 2, you went 4 full doses."
"I couldn't do 5, I thought it would kill me."
"It might have killed me"
"What?"
He said, "I couldn't give you another... I saw what you were going through..."