It's been a while since I updated, so I thought I'd post what's been happening over the last several months.
After chemo wrapped up in September my oncologist ordered a CEA test (blood test for tumor marker). 0.0-3.0 is normal range. I got 1.6, and texted my wife and said, "normal CEA test results". 20 minutes later my doctor's office called and said that since my previous CEA was 0.9, it had nearly doubled in a few months, even within the normal range, she wanted to order a new colonoscopy and CT scan out of an abundance of caution. Ugh. Bottom line: false alarm, all were clear.
January 2021 CEA was 1.3 (good). April 2021 CEA was 1.1 (good).
April's CT scan shows a 3mm nodule in my lower right lung. That's the thickness of 2 stacked pennies. Tiny. Colon cancer often metastasizes in liver or lungs. I get my test results on the patient portal, so I got it Friday evening, and had the weekend to stew about it until I met with my oncologist the following Tuesday. Being a worrier, I googled and researched. Research showed that if you pulled 100 people off the street and gave them a CT scan, 50 of them would have a tiny nodule like this in their lungs. But, this is also how cancer metastasizes... they start small and grow.
I visited my oncologist Tuesday for our normal appointment. She was very dismissive of the lung nodule. Her reasons are:
- They are common, and 99% of the time, nothing meaningful.
- This is tiny, not big enough to biopsy, or run a PET scan on, etc... Needs to be 9-10mm to do anything about it.
- The standard approach for an incidental finding of a micronodule like this is repeat CT scan in 12 months to see if it's grown... I'm already doing full chest and abdomen CT scans every 6 months, so we'll check it then.
- If, in 6 months, its doubled in size or more, then we'll be concerned. But these micronodules are almost always nothing. If it is something, it's treatable. Surgery to remove a small chunk of lung tissue, then more chemo, then carry on. I've been on this battlefield before.
So, given that she's proven herself to err on the side of caution in the past, and she was so dismissive of this, I left the appointment feeling better.
Having said that, it's obvious to me now that for at least the next 3-4 years, this is going to be the routine, run a test, maybe get a weird result, run more tests, have more discussions, and hopefully avoid bad news about recurrence or spread... But the thought will be a constant cloud hanging over my future. Sitting here in mid April 2021, my next tests are October 2021. So, the clouds are off in the distance.
In a strange way, one of the silver linings of facing your mortality with a disease like this is that your focus changes. That's not to say I'm some sort of Zen font of wisdom now. Far from it. But, I value time much more than things now. At 51, I'd love to have another 30-40+ years of life with my family and friends. But, I can't guarantee I'll live another 30-40 minutes. So, I'll end this post and resist the urge to give you a string of platitudes about life and love. You know.
Next post probably in October 2021.