CT Scan and Markings

Today was the CT scan to gather information for the radiation treatments. It went quite smoothly and was similar to previous CT scans with a couple of exceptions.

The first was that I won’t get a report of the CT scan findings. The information is given to the radiologist to plan the treatment. The simple explanation is that he looks at all the CT slices and indicates which areas to target. This input is merged with the scan data and will drive the radiation device to focus radiation to the areas to be treated, moving me on the table and the head of the radiation device to focus the beam to the correct spots. Computer “magic”!

The second exception was the “Markings”. I was expecting this and they are permanent tattoos used for aligning me to the machine. I thought there would be several + marks on my chest. However, what actually happened was two small dots, one on each side of my torso and unless you’re looking closely, you might miss them all together. I’m good with this.

Schedule is confirmed and starts on October 1st for 5 treatments so I’ll be all done on Wednesday October 7th! More awesome news!

For you techies the radiationtreatment isexternal beam radiation. External beam radiation treatment is given with machines called linear accelerators to deliver precise and focused high-energy x-rays. There are two options here and we’ll find out on Sept 28th which one will be used. Intensity Modulated Radiation Therapy (IMRT) or Stereotactic Body Radiation Therapy (SBRT), catchy names eh? Check the photos and descriptions here.

Here we go!

The CT scan & markings (aka tattoos) for the radiation treatments are scheduled for Wednesday September 16. A phone consult for more information on the treatments on September 28th and treatments tentatively starting on October 1st. Number of treatments still TBD.

Moving Forward

We had the call with the radiologist today and received the best news possible in the current situation. The doctor indicated that radiation is a viable and effective treatment for me.

The area to be treated will be the entire area where there is some residual activity showing on the PET scan and all the residual tumor mass. The doctor categorized the area as “very, very small” and the effectiveness of the radiation should be “very good” and greatly reduce the chances of a reoccurrence.

The risks of damage to the heart & lung are “minimal” and the side effects of the radiation were termed as “much less than chemotherapy”. Possible issues are difficulty swallowing, nausea, and tiredness all which are temporary and will resolve post-therapy.

The treatment plan is typically daily, Monday to Friday for three weeks. However, “because of Covid” they are considering 5-6 days. The same overall radiation dose would be delivered in higher daily doses. This schedule is TBD and the doctor is evaluating and will let us know shortly. The next immediate step is a CT scan likely within a week. Radiation treatments will likely start in three weeks from now, so around October 5th.

Shirley and I are grateful to all of you for your support and encouragement and see this as a direct answer to prayer that this option is available to us. God is good, all the time!


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Unexpected

I really didn’t want to write this post, but it’s all part of the journey, so here goes.

Today’s meeting with the oncologist who managed the bone marrow transplant (aka stem cell transplant) procedure to review the results of the August 25th PET scan revealed that there is still some active lymphoma.

This result is not what we believed or hoped for and is quite an emotional disappointment that we’re coming to terms with.

The active area of concern is small and the activity is catgorized by a Standard Uptake Value (SUV) of 3.8 versus an SUV of 19.1 on the March 25th PET scan. Overall my situation is categorized by a Deauville score of 3. Basically 1 is good, 5 is bad and 3 is obviously middle of the road.

Because it’s a middle of the road Deauville score there are two basic options:

  1. Do nothing and re-scan in 2-3 months to see what’s happening. The good outcome is that my immune system kills it off. The bad outcome is that it continues to grow.
  2. Proceed with additional treatment. The recommended treatment is radiation. Radiation viability is yet to be confirmed but highly likely. The good outcome is that radiation kills off the remaining cancer. The bad outcome is it doesn’t work or can’t be done and we proceed to more aggressive treatment options with higher risks. 🙁

Current plan is to meet with the radiologists in the next 1-2 weeks. If they concur that radiation is an option the treatments are likely to begin within another 1-2 weeks. Treatments are estimated to be 5-10 days of daily radiation on an out patient basis.

We are continuing to believe for complete healing and so much appreciate your concern, support and prayers.