Friday, August 25, 2006

A visit to the oncologist, wherein a core sample is taken, and data is spouted

Deep from the bowels of managed health care, a whimper goes up.

"Do you have any idea when the doctor will be able to see me? We've been waiting for two hours now."

And the trees whisper a gentle "nooooooo. . . . "

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I'm torn between reporting on the experience that was our first return trip to the oncologist or trying to make sense of the volley of data that was hurled at us by the doctor.

Let's start with the data. That's what you're really here for. Be prepared that we may update or restate some of this as we do our own research. Did I mention the whole managed care thing?

Dan is still completely asymptomatic. No fever, no rash, nothing. This contributes to the downgrading of his condition to "yeah, it's cancer, but not BAD cancer."

But! New stuff! And changes! Remember the lipoma? It showed up all black and glucose-absorbing-like on the PET scan. Turns out that sucker is absorbing hella glucose. More than the lymphoma, actually. This has the doctors scratching their heads. What is it, they wonder, their collective brows furrowing.

Since all the brow-furrowing in the world can't beat a good, old-fashioned biopsies, back to the surgeon we will go for more lump-hacking.

Until that lump is hacked and analyzed, chemo can't be prescribed. Here's the good news that we're almost reluctant to mention because our luck is generally crappy: if the lump isn't malignant, Dan doesn't even have to get chemo-lite Dr. T originally mentioned. He gets the Pepsi One version of chemo. Four Rituxan treatments over four weeks, then follow-up in six months. This would be incredible, so awesome and it would mean that our cancer blog is being authored by cancer-poseurs. S'okay – Oprah can go postal on us, a la James Frey.

Should the lump be malignant – okay, I kinda stopped listening at this point. Because the lump is not going to be malignant. Not. Going. To. Be. Malignant.

[Nothing changes if the lump is malignant – the original diagnosis and chemo prescription don't really change. So we got some might-be good news and might-be nothing new news.]


We're still waiting for the bone marrow results, and Dan's got an appointment with the surgeon next Tuesday where they'll make plans to hack the lump and install the portacath. It's out-patient, but will be done at the hospital. And Dan needs another bit of irradiated testing in the form of a MUGA heart scan. (Keep the light on for us, Doctor's!) No idea when we'll be able to get in for those procedures.

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