On The Move?

If you've read my previous post about test results, you know that I was concerned that the comparison was done against a CT from October. I spoke with wonder nurse, Stephanie, about my concerns and she agreed. She wasn't happy with the lack of information on the CT results. Fast forward a few days. Not only do I have updated results compared against both the 10/10 CT and the 12/2 PET, but the data has changed …. in ways I didn't expect. The good news is that the tumors in my neck are stable and some are still shrinking, just not by much. The not so good news? My cancer may be moving to a new location, namely my liver. Stephanie calls me Wednesday afternoon to give me the news. She indicated they wanted to get me in for a biopsy as soon as possible, hopefully by Friday but no later than next week. Early turned out to be Thursday morning. Note: I received three calls in the course of a couple hours late afternoon/early evening on Wednesday from a number I didn't recognize; I don't answer calls from numbers I don't know. I decided I better check voice mail, only to find I have four messages: one from Dr. Kocs office and three from the hospital on pre-biopsy instructions. Luckily, hospital staff where still around when I called back early Wednesday evening. 

I find out I can't have anything to eat or drink past midnight, not even coffee. Oh no!! Arrival time is 9:30 AM. Bring a driver and don't expect to go to work for the remainder of the day as I will be mildly sedated. Wow! What a shock! Hubby and I notify our employers that we would not be in on Thursday.

Mike and I get to the hospital a little after 9. There was no one around at the outpatient surgery registration with at least three patients waiting to check in, me being one of the three. I am ready to get this show on the road! We finally get checked in and taken to my pre-op room, number 13. My anxiety went up a notch!

I had the best pre-op nurse. His name was Clay. A big red-neck country boy. We had so much fun joking around and trying to get a reaction out of Hubby. Anyway, he took very good care of me and a great time was had by all before they whisked me away to get the biopsy.

The biopsy room was equipped with a CT scan and ultrasound. The doctor was planning on using the CT, the ultrasound, or both to perform an image guided biopsy. First, they did a quick scan on the CT to make sure they could see the spot on my liver. Then they found the same spot on the ultrasound. They turned ultrasound monitor so I could see the little sucker responsible for my Thursday AM date; it was pretty cool. The spot is very, very small.

After looking at the images, Dr. Johnson came to talk to me. Because the spot is so small he isn't sure he can even get a good sample to test. Add to the fact that the "mass" is next to an artery and a vein (why do all my tumors have to be near structures?!) increases the risk of the procedure. Odds are good, based on location, that we could have bleeding issues post biopsy, which would put me in the hospital for a couple of days to monitor and stop the bleeding. What?! Hospital?! Do we proceed or do we wait?

Dr. Johnson called Dr. Kocs to confirm that, if the spot was indeed cancer, that my treatment protocol would change. He also wanted to get Dr. Kocs take on the options laid out in front of us. At the end of the day, the decision was mine. Dr. Kocs agreed that the treatment protocol could change if cancer was found, but he also agreed that waiting a month or so would be beneficial as well. What to do, what to do? My gut told my safety first but I wanted to chat with Hubby. He agreed. Let's make sure we can do the biopsy safely without risking hospitalization. All in all, whether the spot is cancer or not is not going to change my diagnosis. I still have MBC, I am still stage 4, and I am still terminal.

So we call it a day, they take me back to room 13, take out the IV, I get dressed and I am free to go, only to return in a month or so. I still have a chemo session scheduled for Friday, which I will keep, then an appointment with Dr. Kocs to discuss treatment options late Monday afternoon.

The raw data of the revised scan results is below. In additional to some shrinking lymph nodes, mostly stable lymph nodes, and the liver spot, it also shows a 6 mm lesion on the T11 that is consistent with previous scans. How did I miss that? Anyway, my take is that Taxol has done all it can and we are probably ready to move on to the next treatment option, whatever that is (there is a long list). Even without the biopsy, I want to chat with Dr. Kocs about moving on to the next step. I don't want to give the cancer a chance to get a good foot hold in any other part of my body, nor do I want it to start growing again in my neck. I am also going to ask for anti-anxiety meds. I find I am really struggling with anxiety like never before. I am feeling a bit overwhelmed these days and I can't shake it. I am not afraid to admit I need help.

Isn't it amazing how different the results were reported after a more thorough look. Kinda scary, actually. Can you imagine what could have happened? The initial results indicated that the tumors were getting smaller, which isn't exactly true; they were stable with some shrinking. To me it is obvious the Taxol is not working anymore. What would have happened? Would my bad boy grow again and put too much pressure on the carotid artery? Scary stuff. The lesson here? Trust your gut! Be aggressive about your own health care! Ask questions and push for what you need/want!

I will post again after my conversation with Dr. Kocs on Monday. Keep the prayers and good vibes coming!

Exam: CT CHEST AND ABDOMEN WITH CONTRAST Patient: BISHOP, VICKI Exam Date: 01/31/2020 DOB: 12/06/1956 At the Request of: Patient Age: 63 DARREN KOCS MD Patient Sex: F 2410 ROUND ROCK AVE ARA MR #: 2113432 SUITE 150 Exam Status: Routine ROUND ROCK, TX 78681 Accession #: 30423940 CT CHEST AND ABDOMEN WITH CONTRAST: 1/31/2020 HISTORY: Left breast cancer. COMPARISON: 12/02/2019, 10/10/2019, 10/03/2019, 09/26/2013 TECHNIQUE: Contrast-enhanced images of the chest and abdomen were obtained. Dose lowering techniques were utilized which include adjusting the mA and/or kV to protocol and/or patient size. Total contrast administered on date of service: 150 ml Omnipaque 350 - IV. CHEST: LUNGS: There is biapical scarring. Otherwise, the lungs are clear. MEDIASTINUM AND HILUM: The heart is normal in size. Coronary artery calcifications are present. Normal caliber of the thoracic aorta and arch vessels with atherosclerotic changes. There is no evidence of pericardial effusion. PLEURAL SPACE: No pleural effusion, pleural mass, or pneumothorax is noted. ABDOMEN: LIVER: There is a new 1.1 x 1.1 cm hypoenhancing lesion in hepatic segment IVb. No additional focal lesions are present in the liver. No biliary dilatation. No radiopaque calculi are seen in the gallbladder. SPLEEN: Normal. PANCREAS: Normal. ADRENAL GLANDS: Normal. KIDNEYS: Appearance of the atrophied left kidney is stable. The right kidney is normal. GI TRACT: Small hiatal hernia. Minimal colonic diverticulosis. No obstruction. AORTA / IVC: There is minimal calcific arteriosclerosis of the abdominal aorta without evidence of aneurysmal dilatation. The IVC is unremarkable. OTHER FINDINGS: Right Port-A-Cath in place. LYMPH NODES: The left supraclavicular lymphadenopathy is not significantly changed from most recent examination 12/02/2019, measuring 3.2 x 2.2 cm, previously 3.2 x 2.5 cm. Left Rotter's lymph node has decreased in size, measuring 0.8 x 0.7 cm, previously 1.3 x 1.0 cm. Level I left axillary lymph node measures 1.5 x 0.7 cm, previously 1.3 x 0.8 cm. Change in size is believed to be secondary to positioning and measurement technique. Additional abnormal left axillary lymph nodes are stable. There is no new lymphadenopathy in the chest and abdomen. OSSEOUS STRUCTURES AND SOFT TISSUES: There is a 6 mm sclerotic lesion in the right T11 posterior vertebral body/right pedicle, unchanged from prior examination. There are no additional suspicious osseous lesions. No acute fracture. Postsurgical changes of the bilateral mastectomy with implant reconstruction. Posttreatment changes in the left neck and axilla are stable. IMPRESSION: CHEST 1. Stable left supraclavicular and axillary lymphadenopathy. No new lymphadenopathy. 2. Decrease in left Rotter's lymph node. ABDOMEN 1. New 1.1 cm hepatic lesion in segment IVb, concerning for metastasis. 2. 6 mm sclerotic lesion at T11.