Wake up call

On Friday we met with our local oncologist. She began by asking us what the doctor's in New York City had told us earlier in the week. We said we understood that the PET scan indicated metastases and that another round of chemo would be an opportunity to see if the cancer could be put into remission (cured?), or could be slowed.

The local doctor began by saying that *if* there are metastases to bone and liver then there is no cure that the doctors can offer (I guess you had to work in the cancer community to know this…). They could only offer chemo to try to extend Robin's time. The doctor said pretty much that metastases are always bad news, except for a few cancers like testicular (the kind Lance Armstrong had) for which they can pretty effectively treat even after it spreads.

Well, that seemed to be a different message than we got earlier in the week in the City…..

The doctor went on to explain that PET scans are relatively new and sometimes are erroneous. She said that since this is a "life-and-death" decision point that we need more accurate evidence before we discuss options. So the very first thing to do is to verify beyond a reasonable doubt whether there are metastases. She described three steps:

1. Take regular x-rays to verify if there is any damage to Robin's skeletal structure that lead to her easily fracturing a bone.

2. Take an extensive MRI (80 minutes long) to get a good look inside her bones for any physical abnormalities which would indicate cancer in the bones.

3. Take a more extensive CT scan (with contrast dye) of her liver to detect any lumps (there did seem to be several lumps detected by the combined PET-CT scan done in New York). Wherever lumps are detected they will take biopsies of those spots and have the pathology folks make a determination if they are cancerous.

The x-rays would be completed during our visit (and they all turned out good!), the MRI is scheduled for Monday, and the CT scan for next Wednesday. If anything is found on the CT scan then the biopsy would be scheduled for later next week or the following week.

One downside to all this is that Robin is experiencing greater pain in her legs and hips each day. Bone pain is a symptom of cancer in the bones, so that's not so good. Since Robin's been taking pain meds with increasing frequency, the doctor prescribed a pain med patch for her to wear. Saturday morning she awoke feeling less pain - the patch must be kicking in!