Monday, September 22, 2025

A Little Good News - And Another Pivot

Laura and I met with Dr. Noonan (oncologist) today, and she said:
  • The CT scan a couple of weeks ago showed no growth in the single tumour (15mm x 18mm). More significantly, no new tumours anywhere else.
  • The heart MRI I had last week showed myocarditis (swelling of the heart). All the other heart tests while I was in the hospital showed relatively normal (for me).
    • This was most certainly caused by the months and months of nivolumab and Keytruda (immunotherapy) I had been on. This affects about 1% of people.
    • She put me on a couple of months worth of prednisone to handle the myocarditis.
  • Dr. Noonan stopped the combination chemo/immunotherapy. We may come back to it months from now, but as of today we have another avenue to travel.
  • We'll re-engage the radiation team to see if they'll take me on - we know that the chemo had adverse effects, and the tumour appears stable (two things they talked about with their previous decision).
    • Laura suggested that, if the radiation people decline, we should ask Dr. Wong (my urologist surgeon) if he'd take a crack at it. 
    • I never pass up a chance at major surgery.

Addendum: It's a day later, and I just visited my cardiologist. He confirmed the diagnosis (myocarditis) but made several changes to my meds:
  • Removed the blood thinner (only needed for a year IF I had a stent installed - which I didn't).
  • Removed the prednisone - said that mild myocarditis should resolve on it's own if the source/cause is removed. He's checking with Dr. Noonan regardless.
    • Update: Got a call from my cardiologist - he consulted with Dr. Noonan and they agreed to continue the prednisone - evidence to suggest it's helpful with PD1-Inhibitor caused myocarditis.
  • Cut the beta-blocker dose in half. Heart rate is now too low. And I'm dizzy. So there's that.


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