Friday, April 15, 2011

End of treatment.

I saw the oncologist today. My scan showed no change from last time. There is still a mass in the right iliac fossa which is unchanged, but no evidence of peritoneal or liver secondaries.

What am I to make of this. The mass is a combination of thickening of the wall of the cecum plus enlarged lymph nodes. As it is unchanged I have to assume that it is as small as it can get and that it consists of fibrous tissue. Being a hollow viscus the cecum has a certain diameter and won't shrink down to nothing. Tumors smaller than 5mm cannot be seen by CT so anything left is below the limits of detection. Until something larger appears I must rely on symptoms to alert me to the presence of cancer.

How are the symptoms? Well I still have a noisy stomach as food rattles through new passages made by the surgeon. I still get stomach cramps, but these are lessening day by day and I think are still the last stripes of the chemotherapy. My bowels haven't quite settled down yet to their normal rhythm.

If there is no change since November's scan, did I need to have all that extra chemotherapy? I guess so. In hematology we would call it consolidation. I trust that the chemo was killing undetectable disease and reducing the number of cancer cells remaining in the body. We know that when we get a complete remission in acute leukemia, there may be as many as 1 billion leukemia cells left in the body, and unless we go in consolidating, we will have a relapse within a few months. I guess it is the same with solid tumors.

Anyway, I should have my line out next week and be able to spend teh summer unencumbered.


Hrateful said...

Best wishes for a great summer vacarion!

Bree said...

Dr Hamblin - I wish you an uneventful summer (health wise). May you have wonderful times with your family / friends.

Thank you so much for all you have done for so many years in your CLL research. As a recent caregiver, your writings have been such a wealth of information.

God Bless and may you continue to heal!

Bree from Ohio

The Hartwicks from the CLL list said...

An AMEN to what has been said by BREE! We give thanks to the dear Lord for looking favorably on you. We all continue to pray for you here. You are indeed an inspiration to each of us. We want you to live comfortably to be at least 100! Happy Easter to you and your family! We say a thank you to them, for sharing you with us!

Brian Koffman said...

If only a CT scan could reveal the histology. Anatomy is not a diagnosis and I know at least for me there was alway lingering doubts about how much of my residual node size was from fibrotic scarring and how much might be occult CLL
In you case, the fibrosis seems the most likely reason for the residual mass and I fully expect no change on the CT scan in 6 months
Have a blessed Easter

Anonymous said...

I feel joy at hearing your news! May you be blessed with peace and healing.

Terry and Linda Lee said...

We are very happy to learn your treatment is complete.

I pray you have a wonderful summer!

It seems like more years than seven actual years have passed by since we met you in Columbus, Ohio and later at your clinic. We are grateful for the test you ran for Terry when it was difficult to get here.

Terry is having the last of his scheduled treatments. Today is Rituxan that follows on day 15 of his last FCR-Lite cycle.

He is doing quite well and able to do some of the things that were difficult before.

He was able to do the treatment cycles without any shots to boost production of cells in the marrow. He had no cytopenias and had only a one-week delay of his last FCR cycle due to his platelet count that was slightly lower then his oncologist liked. The platelet count bounced back by today.

God bless you and your family,
Terry and Linda Lee