Friday, December 21, 2012

About that lymph node...

I still haven't seen the radiology report from my scans on Monday, but I did learn from Dr. Curti that the glucose uptake of the node in my right armpit was 6.7 SUV on my previous PET exam (Aug. 1) and is now 8.2. He tells me that while this indicates higher metabolic activity, it's not inconsistent with how ipi works: its pharmacokinetics are slow acting. There are literally billions of ipi antibodies still floating around in my body from my infusions and they will remain on the job for another three to six months.

Unless I have symptoms in coming weeks--new pain or swelling in the right pectoral area--I will wait on a decision to have the node surgically removed until after my next scans (March 25). If the SUV value is down at that time, we'll leave the node alone. If, on the other hand, it continues to pick up steam, I'll schedule an appointment with Dr.Vetto, my oncologic surgeon at OHSU.

This surgery would need to be done in the OR as the node is buried deep within my shoulder; it's not palpable. That raises the specter of certain side-effects, like nerve damage and lymphedema. I experienced both after my groin dissection several years ago, although that was a much more invasive procedure than the single node in my armpit would likely require.

A potential strategic advantage of removing the node is that a comprehensive genotype could then be made of it, which might help in the design of some future treatment involving targeted drugs. The lab could also analyze how much ipi has infiltrated the node, which is apparently of interest to researchers but is of no clinical value to me. Dead or alive, this is obviously one hot lymph node.

It would be nice to have a totally clean slate cancer-wise, but to be only concerned about a single met is still a very good place to be. I'm praying that my ipi-supercharged immune system will eventually take out that node. I believe it can. Compared to where I was a week ago, it's great to know that the rest of my body is clear of cancer for now. I have finally exhaled.


Nancy said...

Peter, we are breathing with great joy. That windstorm that blew through from the southwest the other night was perhaps the collective exhale of those who have been praying, from heaven and earth, for your good health. How wonderful and wondrous that you are free of visible cancer save for that pesky lymph node.

Know that my dear dad whose health is fragile now but until recently was a very healthy guy, is a survivor of lymphoma that struck back in the early '60's, long before cancer was a household word. He is a survivor and so are you. Blessings on this winter solstice day that marks the lengthening of days and the promise of spring and new beginnings.

Unknown said...

So happy to hear that good news, Peter. May God be glorified through your life.