Wednesday, May 12, 2010

A Meeting With The Oncologist

On the way down to Princess Margaret Hospital for a meeting with the Oncologist to discuss the results of my recent CT and Bone Scans, I joked with Linda that I wanted the Oncologist who Heads the clinic there to meet with me, not the Fellow.

"If it's bad news they always give it to the Fellow. She looks more devastated by the bad news than we are."

"No," said Linda, "If its really bad news they give it to the Intern and tell them breaking bad news it part of their training. So what you really don't want is the intern."

As it happens it was the the Oncologist.

But, there wasn't much good news that came out of my meeting with her yesterday, so what there was I may as well give you up front.

Neither the CT Scan or the Bone Scan revealed any new cancerous tumors. So that was good.


Three of the pre-existing tumors in my back have begun to grow rapidly since my chemotherapy was discontinued back in February, one in my right shoulder, one in my left and one in my right hip. Their growth have been the cause of the severe pain I have been experiencing in my back.

So I have been referred to the radiation oncologist this Friday to plan for the radiation of these three areas, although it may not be possible to treat the shoulder blades because they are so close to the area radiated in my esophagus last summer.

And there is another problem. The CT Scan showed I now have water in my lungs, the likely result of the spread of the cancer to my lungs. There are no definite signs of a tumor in my lungs yet, but that is the most likely cause. Almost the certain cause.

I had begun to notice taking Lindsay for a run in the mornings left me short of breath, not panting quite, but certainly breathing harder than I ever used to. And when the oncologist listened to my chest she could detect the presence of fluid.

So it is back to chemo in June to fight off the tumor, or tumors, that is now likely in my lungs. It seems the remaining cancers in my bones were held in check by chemo the last time and, with a little luck, further chemo may keep them in check again.

For a while.

Sadly, chemotherapy will eventually loose it's effectiveness, or the accumulating side-effects may cause irreversible damage to the rest of my system and chemo will have to be discontinued. I have already lost a lot of sensation in my feet and it's affecting my balance. But if the treatment is stopped, then the cancer will be let loose to advance again. Rapidly and aggressively.

At some point, a day procedure to remove the fluid from my lungs may be necessary.

I am also being referred to a range of Community Support Services closer to my home, including palliative care. Not that I am in need of it just now, but the time frame while elusive is suddenly more definable.

Linda and I left the hospital in silence, clutching a page with a series of dates for my upcoming chemo and radiation treatments. The subway rocked and lurched its way back to Union Station and as we transitioned between the subway and the railroad station Linda suddenly said, "Come on move faster, I can't stand this any longer."

"Can't stand what," I asked?

"The music," she said.

If I listened I could just hear the sweet music of a violin playing in the distance.

"Its just too cruel," Linda yelled above the clamor of the crowd.

Then words began to form for me around the notes. "They can't be playing 'My Way'", I shouted back. "That's just not possible."

But, of course they were. It was just the way things went that day.