The Next is Bone Scan

Yesterday at the clinic I asked my oncologist more about the CT result.  A CT scan at the hospital takes the sliced images every 2.5mm.  If the newly found nodule were less than 2.5mm, it would not have been caught.  The oncologist said because the 3 mm nodule was such a small size that it could be missed by angles of the scan, maybe it has been there for a long time and could be nothing.

Hmm.  Then how about 9mm nodule that changed the shape? I asked the 2nd question.

The doctor compared two images that were taken 4 months ago and last week.  “ This is subtle. That could be cancer, or that was cancer but now it’s dead, or an old scar is healing, but to me the new image looks actually better than the last one,” said she.  Overall, she doesn’t seem concerned about the result so much.  Yet for me what she said was not so convincing.

The 3rd question was about T-DM1:  Is it possible for T-DM1 to lose the effectiveness in less than 6 months?

She said yes:  For any chemo it is possible to lose effectiveness shortly because cancer has multiple properties which chemo may not be able to kill completely.  Cancer mutates and develops resilience to chemo.  Also, it could be just suppressed by the previous chemo, not being susceptible to the current chemo.

The 4th question was if I should have a bone scan because recently I have pain around the chest bone; especially at night the pain gets intense and wakes me up.

The doctor said, “ The report said bones were intact. But to give you peace, let’s order a bone scan.”

I have another concern of a headache, which has been bothering me for last two weeks. T-DM1 is not able to go through the brain barrier, and if it’s not working even in the body system under the neck, I have more chance to have brain mets. Yet, I also have some cold symptoms.  This headache can be caused by the cold.  I want to see a little more to ask for a MRI for the brain, and will start with a check up for the ringing in the ears.

After the clinic, I stopped by the medical record department to send a CD of my scan images to Dr. Slamon, from whom I will get a second opinion on 11/13.

That’s about all I can do so far.  I should sleep and eat well and get better from this cold so that I can have a flu shot next.


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