Thursday, April 5, 2007

The Results are In...

And I wish I had better or more encouraging news, but the results of the test provided us with a cloudy future with a mix of good news and bad news.

♫♪Tell me something Good (tell me, tell me, tell me)

Joan was singing Chaka Khan all morning and again said that one line as we waited for Dr. Stephanie Capone to come in and read the results of Joan’s recent Bone Aspiration (*ouch*) and PET scan. I wondered if this being the first time that we ever waited more than five minutes was a bad sign. Who knows but Joan, who pretty much only knows that one line from the Rufus and Chaka Khan song, exhausted even her undying enthusiasm pretty quickly. (Didn’t Stevie Wonder write those lyrics?)

When the Doctor came in Joan called out again

♫Tell me something Good♪

To which Dr. Capone answered

♪Tell me that you love me ♫♪

She understood the song reference immediately. We have the perfect doctor for Joan don’t we?

Well she told us that the Bone Marrow Aspiration had provided us with good news. There was “flow symmetry” and that there was no evidence of new lymphoma in the marrow. Cool, if there had been Joan might have had to go through that again and drilling into one’s pelvis is apparently painful...

The bad news was that Joan’s cancer is more spread out than we ever thought probable. The PET scan showed that Joan had lymphoma in three parts of her lymphatic system; she had lymphatic cells in her Mediasteinem (4), Hilum (2) and her Inguinal lymph nodes (5). Having cancerous growths in that many separate places and places that are far apart brings you up to stage 3 cancer rather than the relatively safer sounding stage 1. This was a big disappointment for Joan and me.

Exactly what Joan looks like in a bikini...

Joan has had two lymph nodes removed from her neck (1) in the diagram. Both were found to be enlarged, but no cancer was present. She had two of her Auxiliary nodes removed (3) and that is where we knew she had cancer before. It turns out that we had the only two nodes with cancer in that area targeted and removed. That area is apparently healthy (great news!) It is the other areas which are now believed to have cancerous growth in those nodes.

♪Tell me something Good (tell me, tell me, tell me) ♫

So Joan is stage three now because there are cancerous cells above and below the diaphragm and they are in three different parts of her body. But she is still low risk and as mentioned before she as an “indolent” or slow moving type of Lymphoma. Follicular Lymphoma is with you forever when you have it. There is no cure, only treatments. But many who have this type of cancer never need treatments because it does not grow. We are hoping in three months when Joan has her next scan there will be little or no progress in those affected nodes.

For now Joan has been presented with two options: Do nothing until the scans three moths from now and see how they look or begin Chemotherapy right away. We chose to wait. If there is a bright spot in the Chemo discussions today Joan will, if ever forced to undergo this destructive treatment, only have a relatively mild technique compared to many that must suffer through this cancer management method. Even better news is that it is entirely possible that the cancer will remiss on its own. As unlikely as that sounds it happens a full 20% of the time in Follicular patients, and we believe that it has already happened to Joan in the past. If Joan does have to have Chemo it will probably start in the summer and it will probably cause her hair to thin.

♫Tell me that you like it, yeah♪

Joan says that her hair could use some thinning. Yeah, I do most of the vacuuming around here. I am not so sure of that but that is just Joan being Joan…

So for now we wait. I hope that you will all continue to pray for Joan and her doctors. Joan has loved all the comments and the over 200 visits that her site has received in a little over two weeks. The many cards and the lovely flowers and candy and fruit have been great for both of us. I promise to have this site updated every couple of weeks to keep you in the loop. If Joan has to get scans every three months for ten years, which is a possibility, but we never have to pump her veins full of poisons both of us will be pretty happy people.

8 comments:

Norm said...

And I thought Joan would have always preferred the "bigger" stage. Thanks for the update. My thoughts and prayers are definitely with you. You know, my insulin doesn't cure me. Never will. But, it's just palliative enough to allow me a vanilla malt every once in a while. I have high hopes that Joan and Doc Capone will successfully mask this thing.
Best regards,
Norm

Anonymous said...

OK, OK, not the best of the best news but nothing sounds too terribly frightening. I guess it's just like always - one day at a time. And with the spirit of both of you together, you are very strong travelers. As always, thank you for the updates Alan and keep loving my sister so well. Joan, my heart and prayers are always always there with you. LOVE YOU!!!

Unknown said...

Don't despair my friends! Listen when my best friend was diagnosed they told her stage 1 or 2 and then after her scans they said stage 3. She did her rounds of chemo and it has been almost 5 years and no sign of it. The good book says "DO NOT WORRY..." I agree with Norm: insulin doesn't make a "cure" but you can still live your life with diabetes all the same!!! I know you can continue living your life and even though its not perfect you can do this!! You are in my prayers! Take care of yourself and keep us posted. Love to both of you!

CentFla said...

I was the only one that was disappointed in the room. Joan and Doc Steph are fired up to bat this thing to the ground so you are all right.

Thanks for signing in. Joan gets your comments emailed to her every time someone leaves one.

Anonymous said...

A doctor that can respond to your musical cues sounds like a perfect fit! I'm confident that things will progress well. Afterall, your book will be pretty boring without some "mixed news" to heighten the tension in the plot now and then. Not to mention that Bernie is much more likely to visit someone who is a 3. . . .

Our prayers are with you both.
Jen

Nancy Monaghan said...

Hey there! Thanks again for sharing your news. My prayers and the employees in Savannah that have met Alan (they think he's sweet)are with you Joan. Seems like you have a new role "I AM STRONG - HEAR ME ROAR" and I know you'll be great at it!

Nancy Monaghan said...

Hey there! Thanks again for sharing your news. My prayers and the employees in Savannah that have met Alan (they think he's sweet)are with you Joan. Seems like you have a new role "I AM STRONG - HEAR ME ROAR" and I know you'll be great at it!

Larry said...

Great to chat with both of you tonight! My thoughts and prayers are with you. One thing that is so important is POSITIVE ATTITUDE. As you know my Mom was diagnosed with a severe form of cancer in 2004 and was given 1 maybe 2 years. Its now 2007 and she is still working and loving life! Just got back from a cruise to the Panama Canal, Costa Rica, Curacao, etc. Keep up the laughs and love life, you will do great! Love, Lar