3rd June 2019 - New scans and oncologist appointment

The day started with the usual appointment at the place where I normally do chemotherapy as Sarah had to insert the needle in my chest, where the port is, so that the CT and MRI contrasts can be directly injected without having to insert a cannula in my arm.

From there, I walked with Jane to the place where I would do my MRI. Exactly as the last time, the MRI felt like an infinite procedure, with the continuous requests to start and stop breathing. But by the end, I had got so used to it that I thought I had almost fallen asleep inside the tube. The CT scan was again much less of an issue - I was in and out in a few minutes.

On my way out of the hospital, I asked for a copy of the scans in order to send them to Heidelberg so that I could get their recommendations on next steps.

The big question now was: will my oncologist send me an SMS this evening as he did after the last scan? It seemed less likely given that I had completed my tests later than the last time but could no SMS also be interpreted as lack of good news this time? I was going to meet him face to face the following day, so presumably the doctor would prefer to give me any bad news face to face.

Luckily at around 9pm, as we were watching a movie with me checking the phone every 30 seconds, I received the following SMS from my oncologist:

“Hi Andrea, good news. Scans show a further reduction in the size for the tumours so a good response to chemo ongoing. See you tomorrow.”

I showed the message to Janey and we both smiled – due to the sharply falling tumour marker values, the news was obviously less unexpected than the message following the previous scan, but it still made us very happy and relieved. And happy and relieved were also my parents and my sister when I called them.

The following day, Jane and I went to the appointment with the oncologist pretty relaxed as we knew that the results of the scans were good. As expected, he was very positive about the report prepared by the radiologists.

Things got a bit awkward when I asked about what these new results meant for the overall strategy going forward, and in particular for the likelihood that I would become eligible for surgery. His response was not particularly positive:

“Conventional treatment in cases like yours does not involve surgery but continuous chemotherapy and possible other forms of intervention, such as ablation of metastases or radiotherapy. I have recommended surgery in a case in the past but the patient only had one single liver metastasis that we had proceeded to ablate. Since it never came back and there were no signs of new metastases reappearing for a long time without any chemotherapy being applied, we decided to proceed with surgery. Totally exceptional circumstances as you will appreciate.”

Although I was not surprised by what he was saying (on the basis of what he had told us during previous consultations), I must have looked quite unhappy so, in the end, he kindly offered to discuss my case at the forthcoming multidisciplinary meeting, where a surgeon would also be present.