Category: Diagnosis

The PET Scan Results

The PET Scan Results

I met with the pulmonology nurse practitioner today, and the PET scan came back with no new cancer, so I’m officially Stage IIIa. That is very good news in terms of my treatment and prognosis.

After that appointment, I went to see the radiation oncologist, where he did a simulation with contrast. Essentially this is a simulation of radiation treatment to mark my body position and location to target the cancer. They gave me four small black dot tattoos that mark those locations.

I start radiation next Wednesday afternoon, and we’ll schedule the rest that day. Tomorrow I meet with the medical oncologist to plan the chemo treatments. More soon!

The PET Scan

The PET Scan

Back at UTSW in Dallas for the PET scan. Got here early, and they called me right back, which was great. First technician tried twice to insert an IV, and both times it felt like he was trying to slay a dragon. He sent in another tech, who got it right away, thankfully. I had to drink what felt like a 55 gallon drum of “creamy vanilla” barium, then they wheeled in this device that was about the size of a food cart and filled me full of radioactivity. I’m just waiting for the Spiderman effect to kick in…

Anyway, I’m sitting her for an hour to let the barium and radioactive goo course through me, more later…

The Brain MRI Results

The Brain MRI Results

Just before the close of business today, Doctor Chiu’s nurse practitioner (the pulmonologist), calls and gives me the definitive word: The brain MRI is negative, no cancer in my brain. Thank you Tammy, thank you for calling and letting me know. Thank you.

Now we wait for the PET scan on December 10th. This will determine if, from the neck down, cancer is anywhere other than my right lung and the few surrounding lymph nodes. It is the final piece used to determine the stage of cancer I have. Right now, it is still considered Stage IIIa, which was supported by the negative brain MRI result. I see Doctor Chiu (pulmonologist) and Doctor Iyengar (radiation oncologist) to review the PET results the 11th, begin preparation for radiation, then Doctor Rashdan (medical oncologist) the 12th to begin preparation for chemo.

The Brain MRI

The Brain MRI

Off I went at holyshittooearly o’clock to Dallas to get my brain MRI. I was given a lovely set of pants and some blue socks, had an IV line inserted, and sat awaiting my time in the tube.

Captain Sexypants reporting for duty

After about an hour, I was led into the room, then placed in an iron maiden for my scan. Essentially, my head was locked in a cage with a small mirror that showed what was directly behind me, pieces of pliable plastic on either side of my arms so that they didn’t touch the MRI machine, a cord to squeeze in case of emergency, and some earplugs and headphones.

As they rolled me into the tight tube, I looked in the mirror which showed a poster of a bridge over the ocean leading to a hut. Nice, right?

Yeah, except for the miscellaneous equipment that was stacked right next to it, which kind of killed the tropical vibe. But I digress…

They asked me what music I would like to listen to. I said, “Wilco please.” They turned it on, and I couldn’t hear anything. After the first scan, I asked them to please turn it up. Massive improvement, now I could barely hear it when the MRI wasn’t running. When they came into the room to administer the contrast, I asked why I could barely hear it. They said, “Oh, it’s all the way up. This is why we have asked them to stop offering music.” Uh, cool.

After over an hour in the tube of fun, I was all done. Now off to the medical oncologist…

The Biopsy Results

The Biopsy Results

The day before Thanksgiving I get the call letting me know that it’s non-small cell squamous cell carcinoma lung cancer. This is usually associated with smokers, but it can happen in non-smokers as well. While any cancer sucks, this is better than some of the other types that it could have been.

Next up is the radiation oncologist, the brain MRI, the medical oncologist, and the PET scan. Again, the MRI and PET will determine what stage the cancer is.

The Biopsy

The Biopsy

We arrive at UTSW the next morning, check in, and are told this will cost us over $5,000. But hey, we’ll have met the deductible for the year! In November. yay.

We are called back, and taken to a room where I’m told to get into a very loud gown with a lovely hair net.

I LOOK AMAZING

Now, I’m not nervous about being sedated, but I had never been under before. The team come in one after another, get my IV line in, all the leads for monitoring in place, and then it’s time to roll on back. One of the nurses asks if I want the pre-sedation cocktail, which will make things very mellow. Damn right, put that into action, sounds good.

It’s worth noting that every single person who came into my room was wonderful and very warm, going out of their way to be kind and let know exactly what was going to happen to me every step of the way.

So, she drops that cocktail in my IV, and they start rolling me down the hallway. Within 30 seconds, I am the most relaxed man on the planet. Into the room we go, where they move me onto the table, ask me some questions, then drop the mask on me. That was that, I was out.

Now, the biopsy is a procedure known as a bronchoscopy. Rather than me explain what that is, watch this video. It walks you through exactly what they did. For those of you with short attention spans, don’t worry it’s only two minutes long.

They do their thing, and then I’m wheeled back to an observation room. I hear talking, but I can’t open my eyes. Eventually, I get them open, and I can somewhat focus on the words being said. Regardless, I almost immediately started asking questions about, well, everything. I remember about 30% of that.

Part one has been answered; the cells they looked at in the room were cancer. Now we wait for the lab to come back with what type of cancer, which may be delayed because next week is Thanksgiving…

The Stoic Doctor Chiu

The Stoic Doctor Chiu

When Doctor Chiu walked in, he got straight to it. Yes, it looks to be lung cancer, Stage IIIA, and it appears to be in some of the lymph nodes in the surrounding area, but my left lung looks good, likely nothing either in that lung or those lymph nodes. The way it is growing, it is probably small cell carcinoma lung cancer. We talk through what to do next. He shares with us a heartbreaking story about his own family, but does so in a way that makes it about my situation, not his. To be honest, his personal story broke my heart, but it also helped me tremendously.

He asks us if we want him to be my doctor. The immediate answer was yes. Okay, so do you want to have all your treatment here? Again, yes, this is the best place I could be right now. So, here’s the plan he lays out:

  • First, we get a biopsy to confirm cancer, to get cells to identify what type of cancer I have, and to see if it has moved into lymph nodes.
  • Next, we schedule a brain MRI and a PET scan, which will tell us what stage the cancer is.
  • Then appointments with radiation and medical oncologists. The radiation oncologist will create a treatment plan for the radiation portion, and the medical oncologist will handle the chemo, immunotherapy, and any genetic mutation treatments that might be applicable.

We agree to this, and he shakes our hands with a slight bow, then leaves the room to get things in order. Before we even get out of the exam room, I get a call to schedule the biopsy. It’s tomorrow morning, no time to waste it seems.

The Thoracic Surgeon

The Thoracic Surgeon

I was fine most of the day leading up to the appointment, but as the time to leave came closer, I started to think about what he might say. Was he going to tell me that it was something that could be treated? Or that I should go home and get my affairs in order?

As I waited in his office, I was completely consumed by the possibility that it was terminal. What a surreal mental state – going from thinking of your life in terms of decades to – in just a matter of days – collapsing that down to years, or possibly even months.

We are called back to the exam room, and in short order the doctor comes in and says, “oh wow, you’re a young man, I was expecting a 70 year old man, because that’s a big,scary tumor.” Yeah, thanks there doc, that really took the edge off the moment.

In a nutshell, here’s what happened:

We looked at the CT scan, and based on that he thought it was Stage IIIa. He said we needed a PET scan and a brain MRI to rule out metastasis (when it moves from one part of the body to another), but if it had metastasized, that would not be good.

After that, we talked about what things might look like if it hadn’t spread anywhere else. His plan was that we should do chemo and radiation, shrink the tumor, then cut out 1/3 to 2/3 of my lung, which would give me a good prognosis. He told me the fact that I’m young, a nonsmoker, and in good health otherwise, that the statistics out there weren’t my numbers, so plenty of room for optimism.

While it started out poorly, I left thinking, “okay, worst case, I get three years and I can work with that. Best case, I am missing part of my lung, but I get to hang around longer.” As odd as it may seem, this all sounded good to me, and lifted my spirits immediately. Why? Because I wasn’t told to go home and wait to die.

That said, this doctor was still not who I wanted to entrust my life with. Tori reached out to her people for referrals, and we were directed to Doctor Chiu at UT Southwestern. Since this is where I was treated for my tinnitus, it was already on the top of my list, but after researching this doctor and the organization overall for their cancer treatment, it became the obvious choice. So, an appointment was made, and soon we met with the stoic Doctor Chiu.


The CT Scan

The CT Scan

Back I went to the same imaging place for the CT. They injected me with contrast and imaged away. I left and went back to work, and at this point the vague idea of cancer crossed my mind, but I thought, “you haven’t been a smoker for over 20 years, you’re young and in good health. You don’t drink any alcohol – hell, you don’t even drink caffeine – nothing to be concerned about.”

Wrong, Doctor Whaley. My doctor called me at 6:00 that night to tell me that it looked like cancer, but that I needed to go to a specialist (in this case, a referral to a thoracic surgeon) to learn more.

Nice clear image of my mass o’ fun.
Fly through my body via the magic of a CT scan! It starts from the top and moves down.
The mass shows up on the left of the screen, but that’s my right lung.

That call was one of two times when I had any significant anxiety or fear about this diagnosis. The next time comes the very next day, when I saw the thoracic surgeon…