A few days after a visit to the hospital, all of the results of scans and tests are posted electronically for me to view. On Thursday, I was viewing the CT scan results of my lungs online and noticed something I had missed in the hard copy report I received shortly after the scan on Monday. There was an "addendum" at the top of the report that said "there is a stable pathologic fracture and lytic lesions" in the fifth rib on the left back side. In English, this means there in a small fracture caused by cancer, along with cancer lesions seen in this particular rib. Amazing that Dr. Bonomi, Doug and I all read this report on Monday and none of us caught this.
This is the first time anything has been reported about the cancer getting in any kind of bone and it scares me a bit. I called and left a message for Irene, my oncology nurse on Thursday afternoon. I was surprised when I didn't hear back from her on Thursday and I finally called her again on Friday morning. She was surprised that Dr. Bonomi had not contacted me yet. Irene answered my questions as best she could, although she hadn't seen the scans the radiology oncologist had referenced (and may not have seen the report yet either). She said although this new development wasn't good, it also wasn't a major source of worry. The bigger concern was still the weight loss I'd been having.
The information from Irene helped but I was still unsettled about this new development. At Doug's prodding, I finally called Dr. Bonomi on his cell phone Saturday morning. He answered right away and as I told him my fears and concerns, he said that this is not a major change and were it not for the weight loss, he would keep me on the current treatment even with this new information. He said he has not yet had a chance to look at the scans that show the fracture and lesion on the rib and intends to talk to Dr. Shah, the one who wrote the report that mentions them, to get more information.
He said as long as I am not having any pain, which I am not, there was nothing else to do. This could heal on its own or it could just stay there. It does not necessarily mean there will be other lesions or fractures in other bones. We just remain watchful and if I notice unusual pains, I let him know.
So I've made my peace with yet another cancer issue. I'm a bit frustrated with the way this information was conveyed - with an "addendum" in a report so subtle that all of us missed it. I am also frustrated that I was the first one to find this addendum a few days later when re-examining the report. Who knows how long this information could have gone on unknown?
This is yet another impetus to getting on that new AZD-9291 drug as soon as I can. Hopefully, it will work at beating back the cancer in both the lungs and the ribs (and keep the brain steady too).
I had the blood drawn for the Guardiant Blood DNA kit on Friday morning. That involved a lot of miscommunications as well. From Irene telling me I didn't need to register at the front lobby and to go straight to the lab and then the nurses sending me out of the lab room to go register in the lobby to the phlebotomist using the wrong tubes for the blood draw and them calling me while I am exiting the hospital garage to come back and have another blood draw to go in the correct Guardiant kit tubes. We finally got it right and hopefully the kit was sent to Guardiant for analysis Friday afternoon. We should get the results around Friday, September 4. Let's hope they find that T790M mutation.
It was a very frustrating week.
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