The official report

During chemo on Friday, I got a copy of the preliminary report from my CT scan with the official wording of what's going on in my abdomen. To be honest, I found this report far from enlightening. The ones I used to get in Hamilton contained a lot more specific information, with locations and sizes of tumours, more information about the ascities distribution and comparative data on previous scans. So, in other words, the report provides information, but also raises questions, which I'll bring up at my doctor's appointment in three weeks.

It's taken me a few days to blog about the results because I'm mentally processing them and what they mean to how I react mentally, physically and spiritually. Today's blog focusses mostly on the physical reaction to the results, as I'm still working on the mental and spiritual components. Sometimes that takes a bit longer.

It's a good thing Dr S verbally mentioned the lack of change in size of the tumours on Thursday when we chatted because it helped me mentally prepare for that news in the official report. In fact, it says, "The overall degree of carcinomatosis is slightly worse than in October." But remember, the CT scan to which they're comparing this one was taken in early October, when I was in the hospital for my operation, and I didn't start chemotherapy treatment until Nov. 17, so the cancer had six weeks to grow. And, Dr. H stated he saw shrinkage from the Regorafinib treatments from the previous scan in the summer. So, it's really hard to compare apples to apples.

BTW - According to Wikipedia, carcinamatosis means: a condition in which cancer has spread widely through the body. I hate the definition, but I can't argue with it.

To be honest, I'm extremely disappointed that after three rounds of chemotherapy (x 2), the CT scan isn't showing shrinking tumours. I really expected improvement, especially given that's what's happened during past treatment cycles. I feel, perhaps, we're not on the right track in terms of treatment and we need to change it up. But, as I mentioned the other day, the docs are happy the cancer is stable at this point and not growing. They're content to continue with the treatment I'm currently receiving. I need to trust their judgement, but I expected more, quicker. Perhaps I'm naive to think I will respond as well and in anticipating a good prognosis for remission.

I did get encouraging news. My CA-125 dropped from where it's been steadily sitting at 355 to 200. So the chemotherapy must be starting to work (it's just darn slow) and the tumours have not invaded any other organs. Apparently, ovarian cancer easily spreads to the small bowel and mine is clear. "In fact, the large and small bowel loops are distributed evenly within the abdomen with no significant tethering or kinking."

My colon is distended with no wall thickening. The subcapsular dome, which always gets flagged as being present on my liver during CT scans, is still there, but since there's no change, I'm not going to worry about it. What's new with my liver is the fluid in my abdomen is causing an indendation and flattening it. The portal, hepatic and splenic veins are patent (which I take is good) and the lung bases are clear (very good).

Speaking of my bowel, I got a little surprise when I went in for my CT scan on Wednesday. To examine the bowel, I needed a cup of contrast inserted into my anus for the scan. While the procedure wasn't really that bad in the whole scheme of things, it was yet another indignity in the whole fight against cancer. I'm sure I'll experience a lot more indignities and procedures - and I'm kinda glad I didn't know about this one in advance - but it was a "oh really?" kind of moment when I found out.

The biggest news on my CT scan, which explains my stomach, eating and vomiting troubles is I have " . . . moderate to large amount of ascities mainly collecting in the anterior abdominal cavity. There are also thick bands of periotoneal carcinomatosis, which is exclusively seen in the left upper quadrant almost completely encasing the stomach, more so interiorly with the stomach being completely collapsed despite being given oral contrast."

In other words, I have lots of fluid and bands of tumours surrounding my stomach, especially in the back, which is collapsing it. But it's not causing any bowel obstruction, which was a concern, and why the extra bonus procedure during the CT scan. No wonder it's hard to eat and drink. I have to be so careful about the amount of food I consume and I'm trying different combinations, times of day and solid versus liquid combinations to figure out what works best for me. But you know me and my love of food, and sometimes it's just so darn hard to deny myself a tasty repast, even though I know I'll pay for it later.

I did realize the other day (and I think I went on and on about it to whomever would listen), I would feel so much better if I could just get my stomach issues under control. The side effects from this chemotherapy are tolerable and manageable, so if I could eat and not throw up, I'd be so much happier. It's amazing how society revolves around food and I think I'm more of a foodie than most, so this whole situation is extremely difficult for me. I have to be patient. But I'm so tired of being patient.

Dr. S shocked me on Thursday because he mentioned inserting a feeding tube so I could get nutrition. What?! No way. Perhaps he was under the impression I was throwing everything up or I couldn't get any nutrition into my body, but I'm doing okay. Luckily, the ascities production seems to have slowed and I'm managing. I'm certainly not at the point  - and hope not to be for a long, long time - where I'll need a tube to feed me. Sheesh.

So the CT report posed more questions than answered and didn't provide the same level of detail as I used to get. During my next appointment, I'm going to pull out some of my old reports and ask if the radiologist can do a comparison, with similar type of information. I think that would help the docs and me better understand the progression on my disease and make better informed choices.

Bottom line, I guess I should be happy there's proof through my CA-125 reduction that the chemo is working, albeit slowly, and perhaps I can expect some changes in the sizes of my tumours and ascities production (and as a result, the stomach situation) in the next while (weeks? months?). I should also be happy there the cancer hasn't spread to other organs. I have to focus on the good news, although I also am in the process of psychologically processing what this all means to me (topic for a future blog).

I've also come to the realization I may need more rounds of chemotherapy, extending my treatment time. Of course, that depends on my tolerance to it. But I'm okay with that. Then there's always the possibility of reassessing the drugs' effectiveness and changing it up. I'm okay with that too. I'm willing to do whatever I can, whatever I can tolerate and whatever tried-and-true or experimental treatment I can to beat this nasty and invasive disease. I refuse to accept this is the way it's going to be. I need more time.

Tina