CT Scan Results

 Yesterday we went to the Cancer Center around 9:00am to get her CT Scan (Chest, Abdomen, Pelvis).

She got done with the scan around 10am and we went to meet with Olivia (Dr. Paluri's APP) to discuss the results shortly thereafter. We had to wait till around 10:45am for the scan reading to be completed.

Olivia came in and read us the scan results, and showed us images of all 3 regions.

The Liver is healing up great, and there are no signs of any tumors in the liver. So that is great and the surgery / liver re-growth has been a great success so far!

The primary tumor in the colon (where all of this started, and it is what sent her into the hospital to begin with) has shrunk so much from the chemo, it still cannot really be seen on imagery.

Every other region was clear except a few small spots in the chest. It showed that there were 3 very small spots in her lungs that were new. Now stay calm, and read the rest of this before getting all worked up.

The three new spots are extremely small. Two of them are 1-2mm, and the largest one is 6mm (the size of a #2 pencil eraser). They are very isolated and not near any major blood vessels or other important things.
Since these three spots are so small, there is no way to biopsy them to confirm what they are. Which means we have to use any other information we have at hand to assume what they are for now. So let's look at that information..

Best case scenario, they are not cancer. There are multiple explanations for what these spots could be that are not related to the cancer. It could be a small infection of some sort her body is fighting off without her knowing. Or several other things. Those are the guesses. The facts that we have to go in line with this side of thinking are as followed. They checked her CEA Level yesterday, and it was still 2.0. Her CEA Level has been a very accurate tool to determine how "active" her cancer is being in her body. With it still being 2 (basically nothing active at all) it leads us to believe that these three little spots are not cancer. If they were active cancer that has spread to her lungs, her CEA Level would more than likely be elevated. The second fact is that she just had three rounds of chemo in the past 2 months. How is it possible for cancer to become actively spreading to another organ in the middle of getting hammered with 3 rounds of chemo, when all it has done during chemo over the past year is shrink and go away? These are the facts we have to support this side of thinking.

Worst case scenario, they are cancer. There are a few explanations for why they could be cancer. Obviously she has had cancer spread in her body, and it could only take one cell floating around (or whatever cancer cells do) and make it to her lungs to begin life there. Maybe this little cancer cell that has spread is not affected by the specific chemo drug that she has been getting anymore, and that is why it has been able to survive over the past couple months. This is a guess. There are a few other guesses on if this is cancer and how/why, but they are just that, guesses. The only fact that supports this side of thinking, is she has had metastatic cancer, and that is what it does sometimes. Yes that is a big fact for this side, but at the same time, the data isn't on it's side (CEA Level & recent Chemo). If her CEA Level was elevated, then yes this would be more likely, but it's not.

At the end of the day, nobody can know definitively what these spots are right now. They are too small to biopsy. There is a 50/50 chance on this being one way or the other right now. So we are in a waiting game. During that waiting period, the plan is to proceed with the Colon Surgery on January 10th. Around 2 weeks after that, she will get a special blood test called Guardant Reveal that she hasn't had before. It looks for cancer activity in her body (different than CEA Level). Around 2 weeks after that, she will get another Chest CT. This is to re-image and see if the spots are: gone, smaller, or larger.
So this will be multiple puzzle pieces in order to know what is going on. 

We already have one piece of the puzzle.. CEA Level. It is on the non-cancer support side. 
The next puzzle piece will be the Guardant Reveal test.
The last puzzle piece will be the Chest CT Scan.

Once we have these three pieces of information, we will more than likely not be on the 50/50 fence anymore.

With ALL of that said, I want to end this post with this. 
It is easier said than done to say "don't worry".. we all know that. Worrying is a part of life. 
BUT... with the information we have at hand right now, the plan is still for her to be NED (no evidence of disease) in the near future. That fact, and the fact that these three spots are so small and isolated that if they turn out to be cancer, they can be treated individually pretty easily are both positive things to focus on.

-If these spots turn out to be nothing, then we continue with the colon surgery, and proceed towards being NED. 

-If these spots turn out to be cancer, then we continue with the colon surgery, more than likely use radiation to zap them (discussed with Olivia yesterday as a potential treatment if needed), re-image and  check levels of course, and proceed towards being NED.

So as you can see, the end goal of the plan is the same either way. NED could be sooner than later, or it could be pushed out a few months, but that is still the end goal of the plan.
Which is something positive to focus on, regardless of what these little spots are.

At a 50/50 chance on these spots, and the fact being that no one KNOWS what they are, I think it is more healthy for everyone to stay on the positive side of this. A few more puzzle pieces coming in and shifting the odds one way or another will help with the knowing.
Knowing the end goal of the plan is unchanged (NED) is the most important thing in my opinion.

Thanks for all the continued prayers and support. We will post up when we get new information or when she goes for surgery January 10th. 

Comments

  1. Thankyou Kenny for this easy to understand and complete description of Christian's cancer journey. This sounds really good. David and I are praising our good God and will keep lifting Christians name up to him and asking for NED to be The diagnosis...

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