Phew??

Well. Yesterday we met with Rob's oncologist.

The nasty that was on the right lobe is almost gone - what the?? I know! Amazing. We are going to celebrate that and not think about it (well, for at least another three months).

There is a bit of nasty on the left lung now. The doc is concerned about it, but the three of us decided not to think any more about it - until his next scan in December. At that time he will have a more detailed CT to help identify what exactly is showing in his left lung.

Right now, we are just counting our blessings and are sooooo grateful for the many prayers that have been said in Rob's behalf.

We are enjoying each other's company and are making many memories - regardless of what will happen. We don't want to take the time we have for granted.

PET Scan tomorrow

Tomorrow, Rob will be going to IMED for his PET scan. He needs to be there bright and early.

He is taking a nap now. Today, he had a full day: got up at 7:30, ate breakfast, went to church (3 hours), and ate lunch. Just like most people, he is taking a Sunday afternoon nap.

I think that some of his tiredness is rubbing off on me. I am exhausted. I am ready for a month-long vacation with nothing to do, but sit on a beach somewhere.

Rob's family will be in town over the next week and one-half. One-third of his siblings live in Florida, so it will be fantastic to see them. Hopefully, Rob can keep up with the festivities and not sleep mid-sentence (in case you are wondering, he is not that bad, yet - but he has an uncanny ability to fall asleep during an action-packed-nail-biting movie).

Anyway...We will be meeting with his oncologist on Wednesday. I will update then.

SUVs: No, We Are Not Getting a New Car

I am not going to wax poetical. I am copying and pasting the 'findings' and 'impression' from the PET scan results.

FINDINGS: There is hypermetabolic activity noted at the site of multiple surgical clips along the medial aspect of the right lower lobe [the doctor is referring to his lone lobe - since the other two were removed, in case you are getting confused] where soft-tissue prominence is evident. This has a maximum SUV of 8.4 and is quite concerning for recurrent tumor. Additionally, contiguous with this site of abnormal activity islobulation of the posterior pleural margin on the right with associated hypermetabolic activity identified on the PET/CT scan with a maximum SUV of 6.2. One additional site of hypermetabolic activity is noted anteriorly along the pleural margin (image 107) where additional pleural-based lobulation is noted.
This has amaximum SUV of 5.2.

IMPRESSION: Hypermetabolic activity associated along the right lung base at the site of surgical clips and with the lobulated pleural thickening, predominantly observed posteriorly although a focus is also noted anteriorly. The appearance is quite concerning for recurrent/metastatic lung cancer.

Looks like we are going to get a biopsy or two.

Rob's comment was, "Looks like we've got a bunch of SUVs and it is not cars."

(SUVs are the level of uptake from the radiation - the higher it is, the greater chance of cancer. Last time, he had two sites with SUVs of: 5.5 and 3.7 [which, incidentally, they said that the 3.7 score was too low to be cancer, HA! Rob proved them wrong, didn't he?] and this time: 8.4, 6.5, and 5.2).

Dog, Snake, and Rat

You are asking me, "What is with the title of this blog?"

Oh, oh, oh! Let me tell you. A dog, snake, and rat have something in common. They are all pets. Yes. Rob will be getting his PET scan on Thursday this week.

In my rush to get the information posted last night, I didn't really answer the burning questions that I posed to the doctor's office.

1. We don't know whether his cancer is back. "It is never a good thing when something that size shows up in a scan. It would be a good idea to get a PET scan to see what kind of uptake the nodule shows," said the PA to the worried wife.
2. Yes, the chances are pretty high that he has a broken rib. Remember the pneumonia he had in May? Well, with all of the coughing and hacking he did, I'm surprised that he didn't break more of them. Poor guy had to hold onto his side for dear life during every cough, for fear his remaining lobe would shoot out through his healed incision.
3. Liver? Don't know. Hopefully, there is no cancer in that organ. The PET scan will let us know how much metabolic activity is happening there.

I had asked the oncologist PA whether we should plan on a biopsy. She said that it really depends on what the PET scan shows, but it probably would be a good idea to just plan on it - if it doesn't happen, great!

So, thank goodness for pets. They tend to calm us when we are stressed. (Or is it the other way around?)

Good News & Markers

We've got some good news and some good news...

Rob's CT came back clean! See! No sense in worrying, right??? (We shall see how well I am doing before the next scan in June.) The report was hilarious: "There is evidence for prior right lower lobe and right middle lobe resection." Really? What gave that away?

The other good news (or bad?): Rob does NOT have the EGFR marker in his tumor. By the way, if you are interested, the tumor was sent to the University of Colorado Health Sciences Center. The actual wording was: "This tumor expresses EGFR weakly by immunohistochemistry and is FISH negative. No predictive mutations are identified. This tumor would appear to be unlikely to respond to EGFR blockade." EGFR blockade is the Tarceva (not having to take that is the good news, or if you are thinking the other way, not having to take that is the bad news).

If you are wondering what FISH is, it is not an underwater thingy that has gills and swims constantly. It is "fluroescence in situ hybridization" which means it is a process which looks at the internal structure of the cell.

So, we have made the decision to not have adjuvant chemotherapy or radiation. At this point, Rob will have CTs every three months, CTs with a PET scan every eight months. The PET scan picked up Rob's second tumor whereas the regular CT did not. However, PET scans often have false positives - no need for the added stress of thinking there is a tumor when there really isn't. Regular CTs have a finer resolution.

Are you thinking, "Well, if the regular CT has a finer resolution, why didn't it show the second tumor?" Yeah, that was my thinking as well. Apparently, the tumor was too small to see on a regular CT, but it showed up with 'hypermetabolic activity' (after Rob was pumped full of radioactive isotopes). I guess anything will show up if one has enough radioactive materials in their body.

Rob hopes to start work soon, if his boss and co-workers will have him back : ). (Call me if you don't, just in case, so we can let him down lightly...) hehehe.

He would love to get back into school as well - provided he can make it through an eight-hour work day and an additional seven hours of school/study time. Can you believe the schedule he was keeping? Yeah, neither can I. It has been fantastic having him home and around (even when he was taking many, many naps).

We are so grateful for the many, many prayers, thoughts, cards, meals, and calls on our behalf. We love you and feel so blessed to have so many wonderful people in our life!

We are not safe yet, but we are glad that the surgery part is over and that there is no chemo or radiation in the near future. YAY!!!!

PET Scan

All I can say is that this PET Scan experience was sooooo much better than the one three years ago.

There was no leaking IV, no bladder exploding. YAY!!! We got in at 7 am and we left about 9 am. Nice and easy. Ahhhh, the joys of radioactive isotopes!

We spoke with Dr. Pearl earlier than expected to learn the results of the PET Scan. His cancer seems to be only in his lung (sigh of relief). There is a 'hot spot' near his heart that is suspicious. We are not sure when we will find out whether it is cancer-related or an infection (as they present the same way on scans).

Tomorrow, we meet with Dr. Michael Collins. He is the cardiothoracic surgeon that performed the thoracotomy with lobectomy three and one-half years ago on Rob (opened him up and removed his right lower lobe).

The kids are doing their best to hang in there. They are having a rough time. Rob and I are plugging along as well. This seems surreal. I am sure that everything will work out for the best.

I am grateful to you; we have had an outpouring of love and support from so many people. Thank you, thank you, thank you.

Until tomorrow...