Four millimeters of anxiety

On Monday morning I drove to Boston for my monthly meeting with the trial team.  The roads were largely empty, as many people are yet on holiday.  When I arrived at the tolls, there were actually more vehicles in the northbound lanes, likely filled with skiers, boarders and snowmobilers.  This meant I had a commute minus the usual stop and go, which is undeniably a more pleasant trip.

After my labs, I met with Dr. Shaw to go over my latest scans.  Although some people are under the impression that I am now disease free (a notion that the media has perhaps inadvertently encouraged), medically my situation has never been characterized that way.  My response to the trial drug was indeed dramatic, but it was a partial response. This is due to the fact that there are still areas of abnormality in both lungs.  The radiologist’s report describes these regions in the following language:

“The patient is status post left lower lobectomy.  There are stable postoperative changes.  Again noted are persistent and unchanged focal areas of interlobular septal thickening with micro-nodularity/irregularity.  There is biapical scarring. There are multiple pulmonary nodules which measure up to 7 mm which are stable relative to the study of 2/24/08.”

Before I went on trial, my lungs were carrying a heavy cancer burden.  Much of what is seen on the scans now may represent inflammation or scarring, not an unreasonable scenario given the amount of disease that was present previously. What the radiologist is really looking for is stability or the lack thereof.  Whether the presenting nodules are benign or cancerous, stable is the next best thing to resolved.

This report noted one nodule that appears to have increased in size:

“In the left lung…there is a 4-mm nodule which first appeared on the study 3/13/09 where it measured 2 mm.  It has gradually increased in size over the multiple consecutive studies.”

Well.  What does this mean?  Undeniably, it could be suggestive of recurrence. However, there are other possibilities as well.  It is a tiny, 4 millimeter red flag. There is nothing to do at this point but watch and wait.  I don’t deny that it makes me anxious, but I have to remind myself that whatever this nodule represents, it is very small and apparently not very fast growing.

Following my appointment, I met up with my good friend Sally, who was visiting family in Brookline.  I joined Sally and her relatives for a preemptive celebration of the New Year. Our champagne toast to the good health of all gathered was particularly poignant, as one of Sally’s sister-in-laws is in treatment for Burkitt’s lymphoma.

After dinner Sally and I retired to the Marriott for a sleep-over, as I had an appointment scheduled for yesterday morning with the orthopedic department. My ankle is healing very well, and I even got a tentative thumbs up for a few runs on the ski slope.  As long as it is a gentle slope, there are no children or other people around, and I don’t fall…I’m good.  I might give it a shot.

I drove back to New Hampshire in a fierce wind and single digit temperatures.  It had snowed overnight, and I’d missed out on a serenade by a pack of coyotes in our backyard.  In addition, David found moose tracks in the woods.  It is always comforting to come home to this rather wild and wooly place where nature is simply going about its business.  My own worries seem inconsequential compared to the daily struggle for warmth and food that is part of being a wild animal.  We, each of us, are striving to get through another day; another night.  I have heard that one of the purposes of the cacophony of birdsong at first light is a roll call of sorts.  Each bird is singing to its neighbors:  “I am here, I am here”. And so we are.

15 responses to “Four millimeters of anxiety

  1. Linnea from the Midwest

    Happy New Year Linnea! There are so many Linnea’s on your blog. I have changed my name to Linnea from the Midwest (from the other Linnea) so it isn’t confusing. I am glad your check-up went well, and that you enjoyed your time in Boston. The way you describe it, New Hampshire sounds so wonderful! I do enjoy reading your blog. You have such a way with words.

    • Thanks Linnea–New Hampshire is pretty darn cool (ok, right now it’s just COLD). And once again, thanks for reading the blog, you’re a true pal. Linnea

  2. Dear Linnea

    I read your blog with mixed feelings i can imagein you must be scared of hearing the word ‘ growth’ but on the other hand you seem to be realistic and I also think that it is not a disaster..wait and see what happens..actually just like the whole cancer process .

    I wish you all the best for 2010 and keep on folowing you!

    Love caroline

    • Caroline, you are right. This is just the way it is with cancer for so many of us; lots of watch and wait. The trick is to enjoy life in the meantime and not to spend too much time worrying about the future. I really do find animals as such good role models in this respect–they really do seize every day. Happy New Year to you Caroline. Love, Linnea

  3. I am living. I am here.

    Here for 71 years.

    Your friends are here.

    Linnea clones are here.

    Over half century we remain here.

    I am living. I am here.

  4. I loved reading your blog. You are such a beautiful writer!! I happened to stumble upon your site since I had Burkitt’s lymphoma. I’m sending up a prayer for Sally’s sister-in-law, whoever she is, as I write this. The treatment for Burkitt’s is severe. But there is LIFE on the other side of treatment!! If she ever wants to talk with anyone like myself who’s been there & done that, I would be more than happy!

    Warmest wishes and I send up a prayer for your health challenges, as well!

    God bless you!!
    john

    • John, I thank you for the comment and the well wishes. I will also be passing your name on to Sally–I understand that there are not so many of you with this particular type of cancer. It sounds as if the Burkitt’s treatment is really harsh, and takes a big hit on one’s immune system. It is good to hear that you made it to the other side. Best wishes to you as well! Linnea

  5. Lineea I am thinking of you, I was, waiting for your scan results and continue now.
    Yes, LIFE is a really a remarkable thing.
    More with our eyes opened.
    My next CT scan is in 2 weeks.

    “For the first time I think I actually am savouring life. I realize, finally, that I am not immortal”. Five years ago NSCLC diagnosis, 10 years ago early symptoms.
    “Finding out you have cancer is a shock. You feel betrayed by life and by your own body. But finding out you’ve a relapse is crushing. It’s as if you suddenly discovered that the monster you thought you’d distanced was still there. It had gone on tracking you in the shadows and wound up catching you again.”

    Phrases in quotes are from a present to my self, new edition of best seller Anti cancer book by a doctor hit in his early thirties by brain cancer 17 years ago, doing well now.

    My new year resolution is to follow his lifesaving advice to improve diet, mind and body. A must read, hope that can help you.

    http://www.amazon.com/Anticancer-New-Life-David-Servan-Schreiber/dp/0670020346#noop

    http://www.anticancerbook.com/

    71 happened on August 3, 2009. I was bold from chemo and now I have a full head of hair like in my twenties, elegant silver. I was born in 1938 in Buenos Aires at the end of 2 year Spanish Civil War with 500,000 deaths. We avoided it, but changed our lives for ever.

    Let go your imagination run as you like and picture yourself surviving in Spain as the young girl in Pan’s Labyrinth best 2006 foreign movie by another Guillermo

    http://www.panslabyrinth.com/

    Start 2010 with fireworks, here is a link with the Baaa Studs that I think is amazing…..
    http://link.brightcove.com/services/player/bcpid1137883380?bctid=17075685001

    • Guillermo, good luck on your scans in two weeks and Happy Belated birthday. I am (slowly) reading the Anti Cancer book as well. Good stuff. I would love to see Pan’s Labyrinth (my daughter says it’s amazing) but I am afraid it might be too violent for me…I don’t do so well with graphic depictions. ‘Tis a shame, because I know it’s my kind of movie. We all got a good laugh viewing the Baaa Studs. Thanks for a spot of brightness on a windy, wintry day. Linnea

  6. Linnea,

    I’ll be the NY Linnea (rather that than the other Linnea with Lung Cancer I think)….I know that you know by now, after all you’ve been through, that the radiologists are doing their best, but with all their technology, nothing is certain. You could have more scar tissue….don’t fret. Use creative visualization, while light, yoga…whatever it takes. The important thing, I think, is how you are feeling and your outlook on life, my friend. Enjoy a Happy, Healthy New Year.

    Linnea

    Linnea

  7. Linnea, you are so right. That said, I can’t deny that it makes me a wee bit anxious. But in the meantime, I will employ every method I can to not just visualize but to manifest good health. And of course, I wish health and happiness to you as well. Linnea

  8. Have you tried the alternatives for your cancer. I am Stage IV NSCLC. Six years ago, I was told I had six months to live. I have been doing alternatives (diet, supplements and detoxing) along with chemo. People can’t believe I have cancer. I would suggest everyone diagnosed with cancer should read Suzanne Sommers book “Knockout”. I believe we are killing ourselves. If you would like to discuss, please contact me. Good luck to you. Lynn

    • Lynn, funny, I was at the bookstore this afternoon and saw Suzanne Somer’s book. I would love to know more about what you do (I am open to most anything) and I will certainly contact you. Thanks for writing. Linnea

  9. If you want me to call you, please leave your phone number on my email–not here.

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