Well, the expedited scans that we got on our first go-around at Holy Cross was followed up with a delayed response the second time. You would think the radiologist would check with me before he makes vacation plans, but no… So not only did we wait all weekend, Monday came and went without results; they finally came in Tuesday afternoon.
So without further ado… after a huge 46% reduction in tumor burden between the baseline scan and Scan #1, the second scan was much less dramatic. Overall tumor size shrank from 14 cm to 12.8 cm, an 8% reduction from Scan 1 to Scan 2. Of the five target lesions, three shrank, one increased by 1 cm, and one had a very very small increase. The good news was the increases were in the two smallest tumors; the larger ones in the spleen and liver continue to shrink by double-digit percentage points.
There was a mixed reaction to the news. A bit of disappointment this wasn’t the dramatic drop from the first scan, combined with the encouraging view that it is considered “stable disease”, sort of leaves us with a “this is good but not great” feeling. Of course, this is just an initial reaction, and as the bigger picture is digested, this scan will feel more and more positive. The first scan results likely set everyone’s expectations unrealistically high; I am still taking a trial medication and have a fairly serious case of melanoma. If you told us back in March that the tumors would have shrunk in half by my second scans, we would have taken that in a heartbeat. Keeping the bigger picture in mind, no matter how much optimism is present, will help weather the ups and downs of recovery. It’s not always a linear progression, and the reality is that stabilization of malignancies is really considered a victory.
What to do now? Well, the last six weeks have been a lot of fun, and a lot of moving around, and not always sticking to everything we did for the first twelve weeks. Supplements have been used less, diet has relaxed much more, and lifestyle did stray a bit from the much stricter “rest and healing” that permeated our lives in the late spring and early summer. Plus, there was that six day hospital stay last week that didn’t help my immune system beat on these tumors. So, with scan #3 looming in mid-September, there will be less fun had through the end of summer. There will be more meals at home, more shopping at Whole Foods, more downtime and reduction of social activities. Yoga time and supplement intake will increase. Prayer for strength and healing will continue unabated. Awareness of my need to heal will remain the #1 priority, but with a little more emphasis on the “healing” part and less on the “it is working – whooo hooo!!” part. This grand experiment inside me will continue to be refined and perfected, until we are on the best possible course of action. Round 2 of T.J./PD-1 vs Melanoma goes to us, although in much less convincing fashion than Round 1. It is a good reminder that this battle won’t be won by one dramatic swing of the proverbial bat, but by grinding it out one small victory at a time.