Cancer Lesson #48: If your cancer doctor calls you after 5 pm at home, it probably isn't just to chat. Bruce got a call from Dr. S last night. He had been looking at the CT scan taken earlier that day just for radiation prep and noticed a change in the tumor size. The tumor has made "significant growth" since the CT scan taken less than 2 weeks ago. This is not good. Dr. S asked Bruce to go straight to a pharmacy that night to get a cervical collar and that he needs to wear it pretty much 24 hours a day. The size of the tumor is threatening the strength of the vertebrae it's attached to. Nobody is sure at this moment how compromised the vertebrae is, but if it does crumble, Bruce is risking paralyzation. This is tough stuff to deal with. Very real, very scary. Although the collar is doing a super important job in protecting Bruce's neck from collapse, it is also a huge visual reminder of what is happening. There is no more pretending that everything is normal for a moment or two for any of us as the bright white of the collar is functioning as a blinking neon sign reading "DANGER! DANGER!" in our minds. I am sure we will get used to it, as we humans have an amazing ability to normalize so many strange things, but right now it is a painful reminder. We knew the collar was coming eventually but thought it was still a few weeks out. The picture quality is terrible, Bruce, so understandably, did not want to pose for a picture, but feels it's important that y'all get an idea of what this looks like.
For him, this is a visual he can't hide from strangers. Some insensitive jerk asked Bruce this morning in the CANCER CENTER WAITING ROOM, "So, did you injure yourself or something??" Bruce was totally not expecting this reaction and just gave the guy an angry look to which the man responded by asking again and which Bruce ignored. When we got into the privacy of the exam room we talked a little bit about how we should have seen this coming and that it's important for Bruce to come up with a stock answer for obnoxious strangers. I think "bitten by a rabid squirrel" was at the top of his list.
Dr. S wants to speed up the time frame for getting a specialist involved. Originally, we were going to consult with an orthopedic surgeon after radiation was complete. Now, Dr. S is trying to get us an emergency appointment with a neurosurgeon in Louisville. This may still take a few weeks as apparently neurosurgeons are not plentiful in these parts. In the meantime, they have all hands on deck trying to get the radiation program started ASAP for Bruce. We don't have a definite time frame on this...could be as soon as Friday.
We also had an appointment this morning with Dr. K. He works with patients that have more advanced stage cancers and are going through chemo. We talked about what the test results were showing. There are elevated levels of the abnormal plasma cells showing up in Bruce's blood work. This does not necessarily mean that we are into multiple myeloma, the next stage of this cancer, but it's enough to tell us that further testing is needed. Bruce will have a PET scan on Monday that will give Dr. K a better idea of what is happening on a cellular level. There was also the hint of a possible lesion on the skull that had shown up in the bone scan and the PET scan will give them a closer look at what is going on there. The following week Bruce will have a bone marrow biopsy (quick but painful outpatient procedure). They are still waiting for the results of the 24 hour urine analysis which should give them some pretty telling information also.
So that's the update. We feel pretty thoroughly overwhelmed at the moment. A lot of information and emotion to process while we are waiting for the next few pieces in the path to come together. On a positive note, Lucy is totally back to normal, not even many cold symptoms today! They are home from school due to a teacher training day....HUGE thank you to my girl, Brandy, for coming over to hang with them while I went to the appointment this morning. The only medical thing left on the schedule this week is Bruce's dental appointment to get his teeth protected before radiation. Lucy talked me into helping her make an apple pie today and I am hoping that's the only thing I have to blog about tomorrow.