The CT scan results were pretty much what I expected: the cancer has been further reduced but not eliminated. The oncologist describes it as "almost complete response", which even without the "almost" is still a pretty vaguely defined term. The cancer in the bladder itself was greatly reduced the last time, with further progress this time. In the case of lymph nodes "complete response" means they have all shrunk to below 1cm, whereas I still have one that's slightly over. But the oncologist regards all this as an excellent result, and left it up to me to choose between the following options:
1. Continue with a couple more rounds of chemo now.
2. Take a break and do another scan in 3 months or so, and see how it looks.
Well, that was easy! Vacation!! I'm going with option 2, and I'm certainly not doing chemo in May-June when we have our Sunriver vacation with the Brown family, and before that Abby and Oliver will be in town. I have to take them on some hikes to whip them into shape for their planned backpack going the full length of Vermont; with our lack of snow we may even be able to get fairly high. In altitude, I mean. But then I'm not doing chemo in the later summer either, since it would interfere with hiking in the high country. So only under the most dire circumstances would I consider more chemo before late September.
What I find strange in all this is that you'd think that if any cancer at all remains, the odds are it will begin growing again. Ma chi se ne frega? (A nice Italian expression for "who gives a (fill in with appropriate obscenity)?.) This will not even enter my mind for the next 3 months, and is completely irrelevant for today. Casting modesty to the wind, I really have honed my "live for the moment" philosophy to a fine edge. In the waiting room today (while Wendy was still on a conference call down in the parking garage, discussing "functional excellence", a term I've never understood but presume is better than dysfunctional excellence) I wasn't even thinking about the CT conference about to happen; I was too absorbed in contemplating the blowup algebra and the Artin-Rees lemma.
We also talked about this new immunotherapy. It turns out it is already being used without FDA approval (I didn't realize you could do that). But as the oncologist remarked, "there is no free lunch", and the immunotherapy has some bad side-effects too. He told us about the worst case among his patients, some poor guy whose reaction included inflammation of every muscle in his body. It was quite serious for a while but they did manage to control it (and stopped the therapy). The mechanism of the immunotherapy is quite interesting but I won't go into it now. The point is that the oncologist and everyone else think I'm some sort of "model chemo patient" and therefore that would be the best option, should it be necessary. But again, that's way too far in the future to even think about.
Well, I don't know if I'll have any more posts for a while. Meanwhile, the
the bad news is that I no longer have an excuse for shirking my committee duties!