Met with the radiation oncologist and the medical oncologist today. It ran 4 hours and was, without a doubt, some of the most intense focusing that I have done in my life.
In summary, this is what I took away from our meetings.
The doctors do not think that the spot in my upper left lobe is a tumor. They think it is too regular and round in form to be metastatic. This is good because it means that then there are only two tumors in the lower left lobe, plus lymph node involvement at the mediastinum, resulting in a preliminary diagnosis of stage 3, B cancer (out of 4 stages). But I need to have a PET scan, which is a full body scan, following an injection of radioactive sugar solution into my body, viewed on a type of CT scanner. If there are areas of fast growth, ie tumors, they will show up brighter on the PET scan than other areas. The doctors are looking at throughout my body, including my bones for possible sites for metastasis.
Then a brain MRI to rule out brain involvement. The brain is going to show up on the PET scan according to my daughter, because it is active all the time, so the PET scan results can't be relied on there or in the kidneys or the bladder (which is different than I originally wrote here--good thing she's on top of this!). They did some physical testing today to measure basic brain function, which involved standing on my feet with my eyes closed, then standing on one foot and then the other, and I passed with flying colors there. But of course that is not definitive.
If there are no other areas that indicate cancer, then I am stage 3,B and they will next do a mediastinal biopsy of the affected nodes to get a better read on the exact type of cancer it is. This will help them devise a chemotherapy protocol that is more closely tailored to the type of cancer that I have.
And after that, next comes treatment. This would be 7 weeks of radiation and chemotherapy. It would be a big hit to me, but the end goal is to put the cancer in remission and maybe ultimately cancer free.
If there is metastasis in other parts of my body, this would put in me in stage 4, and that would mean a further biopsy is not necessary and that only palliative treatment would be indicated. They would be trying to keep me stable and not get worse, in other words. At that point, I would consider more experimental treatments or clinical trials, because I would have not much left to lose. The doctors have no problem with me seeking a second opinion from either within or outside Group Health. Of the 4 folks that we met with today, I was very impressed with the knowledge and skill of the physicians and the radiation oncology nurse. When you are good at what you do, you don't mind if others are consulted on their opinions.
We will deal with this as it comes up. The brain MRI is set for October 12 and the PET scan will either be Monday or Thursday of next week. Once again, patience is indicated. Of which I have less and less.
The prognosis after 5 years seems to be around 20-25%.
Life on the edge. What a concept.