From speckles to spots

Quent had his second CT scan today and then we saw Dr Savage.

News

The bad news is that the speckles have grown. They have approximately doubled in volume since October. I am devastated by this news. Static speckles was the only thing I wanted for Christmas. Now we have spots (approx 12mm each).

There was some encouraging news, however. The cancer seems to be "moderately agressive" (not static, not fast growing) and Dr Savage said that he feels quite reassured. It does not appear to have spread to the liver, bones or brain. We need to watch it closely but we don't need to set a date for treatment yet. Dr Savage expects treatment will need to start sometime during 2007.

Dr Savage also mentioned that there are two more drugs about to be licensed for kidney cancer, so there are 4 new drugs in this area in the last 2 years. With such an increase in treatments all of a sudden, they are still working out how to put them together.

Next steps

Because the CT scan gives 400 times the radiation of a chest X-ray, Dr Savage said we will monitor with chest x-rays (each month) for about 6 months, before doing another CT scan - unless Quent starts feeling unwell or the x-rays show significant change.

Quent confirmed he would like to be treated at Charing Cross, with the triple therapy (the one that's more toxic but has a chance of better life extension) when the time comes.

Q&A

Quent asked whether the growth is linear - ie. can we expect the speckles to double again in the next 2 months. Apparently it's not as neat as that and we can't predict growth rates.

Quent also asked whether his immune system is trying to fight the cancerous cells and failing or failing to recognise them as bad. Apparently, the understanding of how the immune system interacts with kidney cancer is fairly modest. Immunotherapy sometimes helps, but it is still unclear how or why.

Finally, we asked about a heart and lung transplant. He said this has never happened for a cancer patient. There is a shortage of donors, it is a huge (and expensive) operation and there is a chance of microscopic spots being elsewhere and then growing.

Conclusion

I am aware that your view of our situation is dictated by my mood and this is a gloomy post. The truth, though, is that things are progressing pretty much as expected. There is still a while before treatment, then a good chance Quent will respond - as well as several new drugs to play with further down the line. We may not have static speckles but there is still good reason to have hope.