Time for a cancer update

If you're interested in reading about the cancer, this is it. If not, pass it by, this is ALL CANCER INFO day.

I promised I would use this blog to update about the progress of the cancer and treatments, and which is currently winning. Here's what's new.
On Tuesday I had a brain MRI to follow up on the IMRT therapy that I had on the pituitary tumor in August. Seems like yesterday, but I think it was August. When I went in to see the rad onc we were talking about other symptoms in general as a lead up and I mentioned the superior vena cava syndrome that I had angioplasty for, in August, but had not had the radiation consult because the Dr. was on vacation. Dr. Suh seemed confused, as I was, why only angioplasty was done to clear scar tissue from the veins, when there is obviously pressure on it from enlarged mediastinal lymph nodes. He examined me quite thoroughly for SVC syndrome, noted my puffy face and eyes, as well as the proliferation of new veins across my right upper chest and arm. He asked if my shortness of breath had improved since the angioplasty treatment. Am I reading too much here to think that it should have? Dr. Google said it would.... I have scheduled a follow up with the vascular surgeon next week, and Dr. Suh wants me to call afterwards, and says he will also talk to Dr. Moore, my medical oncologist. Since I'm doing chemo, I don't know if focused radiation to the offending mediastinal nodes is still an option. I also wonder if it means that the chemo is not working, if the nodes are still swollen. I HATE feeling like I'm the go-between for all these specialists who don't really want to talk to one another. And each one wants to treat me with his own tools. Remember the saying "to a man with a hammer, every problem is a nail"? I wish they would all confer at the same time, preferably with me in the room! I know it's not going to happen, of course, and I guess this sort of tunnel vision is the price we pay for specialized medicine. It makes you wonder if it's always better.

Anyway, sort of casually at the end of that conversation, he said, " that spot we've been watching has grown so we need to get you scheduled for gamma knife." This is a tiny spot that showed up in May but too small to define, then had not changed in August, when the pituitary tumor was noted, so thought not to be cancer after all. Well, now it has grown, definitely a tumor. Still quite small, three mm or so, but needs to be zapped. After having the sequence of IMRT in August on brain tumor #2, I find myself being thankful that this one is in a location it can be treated by gamma knife. Sure it's a pain, and the metal frame screwed to the head not so cool, but it's done in one day. I'll take it. I am also immensely grateful that these are still appearing one at a time so whole brain radiation is not yet necessary.

Just to make this a full cancer update, the right lung does not show any signs that it might decide one day to reinflate. One of those odd occurrances, I guess. No one has seen this before, but my thinking is that it's because the diaphragm on the right was already dead and can't pull down to open the lung. The breathing I was doing on that side was totally with chest muscles, not diaphragm. I don't know enough about the anatomy but for some reason now that the pleura is attached to the lung, the chest muscles don't have any control. Had I known this would happen, I would have opted for a permanent pleurex catheter (chest tube) that could be drained when fluid built up. This is way worse than being filled with fluid.

Oh, yeah, I also saw a shrink that deals with oncology depression only. (Talk about a specialist) I had asked the dr. about an anti-depressant because the tears come too easily, and once the conversation turns to my cancer, they flow and I blubber. End of conversation. It's embarrassing, mostly - I'm not a pretty crier. And it only lasts for a minute. It's not like I'm clinically depressed, just sad to be dying of cancer and I cry about it in short bursts. So we went through a long question - answer series and she gave me an older drug, Celexa, to try. When I went online to ask Dr. Google, who referred me to Dr. Wiki, I found out that this drug was also use to reduce the pathological crying sometimes seen in stroke victims. I thought, yeah, sometimes that's what it feels like. But then I saw the common name given to that syndrome and nearly peed my pants - "emotional incontinence." Yeah, that about sums it up.