Some Encouraging News

I wanted to provide a brief update as we had our consultation with Dr. Yorio yesterday following the CT scan that I had done on Monday. Some really encouraging news to report. The tumors are shrinking, significantly.

The large one in my right lung has shrunk from 4.2 cm x 3.5 cm to 2.2 cm x 1.4 cm. One other tumor in my lung barely shows up, and the other two items appear to just be non-cancerous nodules (likely scar tissue that most people would have). By area, the large tumor has shrunk by 79%.

The primary tumor on my left kidney has also shrunk, but not as dramatically. It went from 8.7 cm x 7.4 cm to 6.1 cm x 6.7 cm. By area that is about a 36% reduction. Still great progress, and intuitively makes sense as it was much bigger to begin with.

We're not out of the woods, but all of this is very (very!) encouraging. If I continue to respond positively to the medication, the hope is that the tumors in the lungs get to the point where there is no evidence of disease, and the tumor on my kidney continues to shrink. It's possible that this could occur over the next 3 to 6 months. If that happens, the next step would be to seriously consider removing the kidney.

Either way, the plan is to continue with monthly Opdivo treatments for the next 2 years to help ensure any lingering cancer cells are eradicated. Monitoring will likely be ongoing for the rest of my life, though probably not as often.

There is the concern that the cancer adapts to the medication and it stops working. If that happens, we'll change up the medications and go from there. The rate of reduction is an encouraging sign that the medication can win the race before the cancer adapts.

I've included pictures of the imaging for anyone that wants to nerd out. The measurements are provided in the bottom left corners of each image, and there are thin green cross marks over the tumors with the initial images from June on the left, and the current images on the right. The first picture is of my lungs, the second shows the kidney. As a point of contrast for the kidney, it's helpful to look at my healthy right kidney (on the left side of each image) as a point of comparison.

I had my final dose of the Yervoy + Opdivo combo yesterday. From here, it'll just be the Opdivo, which will shorten the amount of time each treatment session takes. Yervoy is the one where the biggest side effects supposedly occur – so far, I've gotten off relatively easy in that department, but we'll see what the next few weeks hold. My next CT scan will be sometime in December, and then about every 3 months thereafter.

How I'm feeling

Humble, reflective, happy, and optimistic.

What I'm thankful for

The team at Texas Oncology and the researchers that have developed, tested, and trialed the medications. Also, the health insurance that covers it all. There is a lot of cynicism and horror stories about our healthcare system, but my experience here, so far, has been aces. And I'm thankful for that.

A memory

It's been three months since my initial diagnosis. I remember the shock and the sudden facing of my own mortality from that day. I was shaking and struggling to process quickly enough to ask the right questions. I probably shouldn't have driven home. I remember telling Amy via Facetime while she was in Iceland. I remember the look on her face – first disbelief, and then shock. Her face trembled.

It's amazing how one adapts to thinking that having your kidney removed is what you're striving for.

What I'm looking forward to

(Hopefully) one day, having my kidney removed. I neglected to ask Dr. Yorio, but it sounds relatively manageable. 1 to 2 days in the hospital, followed by a couple of weeks to recover.

It's amazing what people – and the human body – can do.

Something I recommend

I used to turn on CNN every day, typically while cooking. Now I'll listen to a podcast, put on a record, or put on an episode of Jeopardy. I still stay informed, but I get my news from the Economist and the NY Times. It helps me shut out the noise, and find a way not be outraged by every little and big thing that the current administration does. There are reasons to be outraged, but it's not how I want to spend my energy.

I recommend finding your version of this – the news will always give you something to be outraged about. They don't lead with 99% of people on Earth went to bed last night with a full belly.

Something I ate

Last night I made up an eggplant parmesan. relatively easy, but it takes some time. Probably about 1 hour of active time, plus another 90 minutes to cook and let it rest. Resting for 30 minutes is key to let everything set – otherwise, you just have a big glop. Second time I've made this, and it'll continue to be in the rotation. I loosely followed this recipe:

https://cooking.nytimes.com/recipes/1024453-eggplant-parmesan