Some of you have wondered how things are with my health after my last post about similarities of life with stage four mets and life in the wake of pandemic. Actually, I’m still trying to figure out what’s going on. What’s a result of cancer? What’s normal aging? Why for the past three months have I had a few days each month where I run a low grade fever (between 99-100.7) ache like crazy, am mildly nauseous, and completely exhausted?
This much I know. My oncologist ordered a CT scan in April following three increases in a row in my CA 27-29 tumor marker. It’s not horribly high or anything, but it’s inching up there. The CT scan revealed the following about the state of my bones.
MUSCULOSKELETAL: Extensive metastatic lesions of bone again seen, exhibiting heterogeneous sclerosis, overall extent greater than before although it is noted that even successful treatment of metastatic lesions might result in greater sclerotic
conspicuity on conventional CT; scintigraphy can be useful for quantifying metabolic activity within. Mild inferior-endplate compression fracture of T7, new from previous exam, in association with sclerosis; no significant retropulsion.”
The radiologist providing the CT report noted “Increased extent of heterogeneously-sclerotic metastatic disease of bone, newly resulting in a minor inferior-endplate compression fracture of T7. Advise consideration of radionuclide bone scan or even PET to determine how much of this is metabolically active. No suggestion of developing metastatic disease in soft tissue.” So I had my first ever head to toe bone scan. And this is what it revealed…
FINDINGS: There is diffuse osseous metastatic disease throughout the axial and proximal appendicular skeleton with lesions identified throughout the skull, bilateral ribs, spine, pelvis, and femora.”
Yep. This is pretty much the entire report from the bone scan I had a couple of weeks ago. Well, duh! Oh, and the radiologist did note that “There is bilateral renal function.” Thank goodness! But that’s it for the report. I was confused. Even after meeting with members of my oncology team yesterday and talking with my oncologist later by phone, I’m still not 100 percent sure what’s going on. Like “doubting” Thomas, unless I can see on a screen how many parts of my skeleton light up like a Christmas tree, I will not be satisfied. Yep. I’m pretty big on visualization.
The good news is no soft tissue or organ involvement. This is what we want to hear for sure. The not so great news, the “huh” news, is about the spread of the metastatic lesions, or mets. To me, with all my former-English-teacher-word-parsing, Dr. Googling, obsessive record-keeping, limited scientific knowledge, and attempts to stay fully connected to my body, this news feels unsettling. In looking back to the CT results from September 2018, only a few potential lesions were noted. Now we’re using the word “Extensive” to describe the situation? Hello? How extensive are we talking here? Instead of termites, this house has cancer.
My oncologist, however, seemed nonplussed. No need to change treatments or anything just yet. This bone scan gives us a baseline from which to work. The compression fracture will not repair itself, but guess what? There’s GLUE for that! And radiation if the bone pain becomes too difficult to bear. In fact, she suggests I go ahead and consult with a radiation oncologist.
And still, Rob and I shake our heads and say, “Huh?” What do we really know from this? Not as much as we’d like for sure. How do you plan a life around such generalities, devastating losses, and small victories and joys? What about travel since, I’m classed as high risk for COVID-19? What if we don’t travel? What potential losses might there be?
It appears that the cancer is continuing a slow, steady progression in my bones. So far there is no soft tissue or organ involvement. This is a marathon, not a sprint. I’m going to have to be more careful to avoid putting stress on my bones. At some point I will become a fall risk. I wish I could figure out what’s going on with these bouts of fever and total malaise. But for now, overall, things are pretty good, and I have much for which to be grateful. And I am grateful!
What has cancer taught me recently? A little planning is a good thing; too much planning is a waste of precious time. There’s much more living to be done than hours in a day. Letting go is awfully hard, but it’s the only way to experience life in the moment, to seize the day, and experience every precious atom and molecule spinning and dancing. Don’t look back with regret or nostalgia. The past tense lens, for any of us, does not offer a clear, true view. It is clouded by emotions, fear, longing, and rationalizations. Loving God and loving neighbor is plenty enough to focus on without any religious wars or theological conundrums. The Christ is too big to get caught up in our petty little control wars, too vast to be hampered by our desire to control the divine impulse. Let God be God and hang on for the ride. Life is precious. Most things don’t matter much at all: people do, justice and fairness do, being satisfied with enough matters, and love always wins.
I’m learning a lot from my teacher Cancer. Some of the lessons are so hard, but I wouldn’t miss the aha moments and the wisdom offered. I wouldn’t trade one second of this precious life, and yes I pray for many more years–I’m only human, after all. But I just don’t know, and I’m not going to let that spoil the party. We’ve got some serious living to do, my friends! Thanks for stopping in. Take care. Stay safe. Love all you can with all you’ve got. Live. Really live.