18th May, 2018

Just back from the Cancer Centre. No four hour wait this time, thank goodness. Exhausted by the process anyway. We got good news, bad news and some options. 

The good news:
1. The head MRI revealed that the lesions in Nick's brain are most likely calcified (i.e. dead) tumours, and are most likely nothing to worry about.
2. The beta-HCg tumour marker has come down to a 30 now; one more round of chemo should normalize it. Recall that it was at 90,000+ at the start of this, so the cancer has reponded quite well.
3. Most of the small tumours in the lungs have vanished.

The bad news
1. Most of the larger lung tumours are still there, though they have shrunk. This would explain Nick's persistent cough and shortness of breath.
2. The non-disappearance of these tumours (which are considered inoperable due to their location), as well as Nick's past history of relapse, makes it unlikely that any remission bought through the current regime of chemotherapy will be permanent. The reason for this is that non-seminoma germ cell tumours are heterogeneous in terms of cell types, and the cell type which survives chemo is most likely teratoma, which although not actually cancerous (and so not affected by chemo), can mutate into active cancer if left in the body.

The Options:
1. Nick will return for one more round of chemotherapy, but with an additional week off. Thus he'll start up again on May 28th, rather than May 21st. This wil most likely normalize the beta-HCg tumour marker and buy temporary remission. With extreme good luck, the lung tumours may miraculously vanish.
2. Upon any subsequent relapse, Nick may have the option (if his disease is a good candidate - the tumour tissue must test positive for a certain "C-31 marker") of taking an experimental drug currently under clinical trial in the states. He'd have it administered in London, however. 
3. Nick will have his tumour material genetically sequenced (which takes about a month). This may allow the development of targeted chemotherapy regime, which is specific to his tumour's genome. 

Fortunately, one phrase we did NOT hear in our meeting was "palliative chemotherapy", so that much is good at least. In any case, guess we won't be going back to school until the fall. Hope we can go back then. When will this crap end?

Tanja's dad is out of hospital now, and will most likely be starting chemotherapy for a "pre-lukemic condition" (with a medical name as long as one's arm no doubt.)  He's very happy to be home at least. 

Our thoughts and prayers go out to the folks in Santa Fe, Texas, where the latest school shooting has killed 10 people. This school is about 15 minutes from our friend Mimi's place (in Dickinson), and her daughter's best friend was in fact one of those "locked down" when the shooter was running amok. 

Comments

  1. As my grandfather would say in his infinite wisdom: Keep Punching.

    We are rooting for Nick and the rest of you Greesons!

    Shine On.

    ReplyDelete

Post a Comment

Popular posts from this blog

March 3rd 2021

September 23rd, 2018 - End Game