Round 6 results and next steps

regular
results
milestones
PET scan results confirm the current medical direction.
Author

Colin C.

Published

October 15, 2023

This past Friday Sam had a number of appointments, starting with a PET scan first thing in the morning. A PET scan provides 3-dimensional imagery of where the cancer is in the body, and metrics of how metabolically active the cancer is. We have been anxious for the results of this scan as the data would provide direction for the next steps in Sam’s treatment. At clinic, in the afternoon, the results were back – and confirmed the direction that we are going.

Good results?

For Tina and I, and likely many of you, we hoped for a miraculously good results – that following these latest two rounds of chemotherapy the cancerous mass would finally collapse and be non-detectable. We do not have that result.

At the end of August, following the completion of round four, the medical team communicated their plans to pivot towards a bone marrow transplant1. At that time it seemed evident that the cancer would not fully respond to the planned six rounds of chemotherapy. This is the result we have.

  1. The last two rounds of chemotherapy have held the cancer. The mass is stable – it has not grown and it has not spread anywhere new. … Although the cancer has not had any significant decrease in size, the chemotherapy regime that Sam has been under has been effective at holding the cancer back long enough to prepare the BMT process. We also know that the BMT process is the next best step as the now completed chemotherapy was no longer effective at reducing the disease.

  2. The result are what the medical team hoped and planned for. Plans were initiated over seven weeks ago to prepare for this outcome. If the cancer had grown or spread our conversations with the medical team could have been very different.

The results are good – as they support the plan.
The results are also challenging as a hard road lays ahead.

Highlights from this past week

Appointments

Lots of tests and appointments this past week.

Tests and appointments completed this past week. Most of these were to create baseline measurements of Sam before starting the BMT treatment protocols.
Activity Complete
Eye Exam Complete
Renal medical imaging Complete
Bone marrow biopsy and Lumbar Puncture Complete
Hearing assessment Complete
Pulmonary Function Test Partial
PET Scan Complete
Ultrasound of neck (state of blood-clots) Complete
Dental Assessment Complete
Dermatology Complete

Visits

Sam has been able to connect with friends online.

Friday afternoon Sam and his Uncle Cal had a great connection remembering and celebrating Papa Gord together.

Upcoming

For the most part Sam may have much of this coming week off. There will be clinic visits but the intent of the medical team is to give his body a break and get him as strong as we can before the BMT process starts.

We are looking forward to visits with friends and family.

Victories and concerns

  • We have finished the week strong – despite a long list of bookings we made it through and Sam is in good spirits.

  • We have completed a major chapter in Sam’s treatment. With the completion of this last/ sixth round of chemotherapy we now pivot to the bone marrow treatment plan.

  • It is the beginning of flu season and covid is still out there. In the weeks ahead, as a family, we will be very cautious to reduce our risk of getting ill. If any of us get sick in the weeks ahead it will add challenges to Sam and the BMT process as he will be entering a phase where he has no immune system for weeks.

  • I am continually thankful for our medical teams here. They continue to provide incredible care. They are always open to conversation and answering questions. They have been incredibly pro-active and I am glad we are prepared for the next steps.

  • Thankful that the chemotherapy has been effective at initially reducing the cancer and lately keeping the cancer contained (as indicated by the PET scan). Thankful that these results allow us to move forward.

  • In preparation for the BMT there are numerous items that need to come together:

    1. Due to some timing and logistics we have had to change donors. We are thankful for this current donor who will provide a peripheral blood sample and is a good match for Sam.
    2. We are desiring that side effects both immediate and long-term would be limited. Ideally, that there would be no measurable side effects long term.
    3. The medical team have a huge coordination task ahead of them. All the pieces need to fall into place for the best timing possible.

  • We are thankful for the support of family and friends. Thank you for your notes of encouragement.

  • There is always concern as the cancer remains. We long for the day when Sam is clear of this disease.

Footnotes

  1. See Aug. 26 post for the round 4 results↩︎