Sharks with Laser Beams

The results of the PET scan came in, and Laura and I went in to see Dr. Noonan for all the details. The tumour/lesion has reduced in size slightly from 21mm to 16mm (24%). The intensity (SUVmax) has increased from 13.9 to 17.2 (29% increase).

The SUVmax value increase could partially be explained by the PET being taken on two different scanners (I could see this in a macro view where the background in the image is brighter in the new image).

But in the final analysis, the tumour is a little bit smaller, but a little more intense.

Dr. Noonan referred me to Radiology for a consult to see what they thought.

Yesterday (1 week after the results meeting) I met with Radiology. We spent over an hour going over the scan itself and I was offered a spot in a clinical trial: SIMPLIFY-SABR-COMET.

Standard of care today for my type of lesion is Stereotactic Ablative Radiotherapy (SABR) where they use multiple beams of radiation focused on the tumour, normally given 5 doses over 5 days.

The study is to determine whether giving a single dose of the radiation (equivalent to the cumulative total of the traditional 5 doses) has a different side effect profile from the standard protocol.

The advantage to the medical system would be to increase treatment throughput by 500%. 

The advantage to the patient would be to reduce the time you spend getting the treatment by 80%.

But nobody at this point knows if the side effects between the two methods are similar. 

The assumption is that the treatment outcome would be the same because you are getting the same amount of radiation - just one is all at once, and one is over 5 days.

Because it's a clinical trial, there would be a lot of reporting, bloodwork and imaging (PET/CT/MRI).

So I'm leaning toward saying yes - although I have a few more days to think about it.

3 Months or 5,000km

The PET scan happened last week, and Laura and I got the results today. 

The tumour is not growing, but has increased slightly in intensity. I don't have the actual lab report, so I cannot compare the tumour velocity (tumour size x measure of metabolic activity) with last time.

Dr. Noonan is going to send in a request to see if the radiation oncologists will light me up (5 sessions, 1 per day for 5 days) to zap the tumour.

Regardless, the next check in is 3 months. So I have a whole summer to enjoy.

Rupert Nite is this Saturday, and we head to Haida Gwaii on May 9.

An Even Shorter Update

For shits and giggles I loaded up my history into Google Gemini to see what it would say. Because the tumor growth had pretty much stalled, I was hoping it would come back and add a little optimism into the mix and say "hmmm ... this is not behaving like an aggressive cancer".

Alas it did not. It came back and said "this is cancer until proven otherwise". It also said an important measure in my upcoming PET scan would be velocity of the tumor. 

The scan here was taken about a year ago, and the values the radiologist would look at to determine velocity would be the actual tumor size (then versus now) and the SUVmax (the brightest pixel on the scan - not shown here but the scale goes from 0 to 17.5). So I guess you cannot be just a guy writing a blog and interpret this scan - you have to know what you're doing.

So that's my question - what's the velocity? 

My PET scan is scheduled for April 22, and I see Dr. Noonan on April 30.

A Short Update

As per my last update, the growth/tumour in my pelvis hasn't changed size for nine months. For a cancer to be as aggressive as mine, and see no change, is strange.

When I saw Dr. Noonan last week, her plan is to do a PET scan in three months to see what's what. If it glows like the previous scan (May'25) then there is something metabolic happening. The best explanation is cancer, but it could be something else. If this is the case, she'll push for radiation. The radiation people told me that didn't want to do anything until/unless they see change - but she'll argue that we should handle this growth while it's still small (about 15mm x 15mm) versus wait till it grows or spreads.

If it's not glowing, and it's not spread (ie: glowing somewhere else in my body) then I think I'm in the clear for now.

So there you have it. 

In the intervening months, we're going to plan a trip to Haida Gwaii. 

The Phonecall

I had my latest CT scan on January 12, where we'd see what is happening to the cancer in my pelvis. It had been "stable" since April 2025, and what it does now would guide next steps.

I have an appointment with Dr. Noonan(oncologist) on January 28 to discuss the CT but, as luck would have it, I had occasion to call Dr. Wong (urologist) in mid-December. He saw that I had a CT lined up and said that he'd call a week later to discuss.

Dr. Wong is much more "just the facts, ma'am" than is Dr. Noonan, so I'd rather get the news (good or bad) from him. 

So here's the news: 

• I've had a nasty cough for about 8 weeks now (nothing else, just a cough). When my GP listened to my lungs a couple of weeks ago, he said they were OK - and that if I had pneumonia I would not look as good as I did.
• Turns out, the CT showed infection in my lungs. I'm gonna get that sorted out this week (I have an appt with my GP on Thursday, and am trying to get in earlier).
• The tumour has not changed size, or metastisized anywhere else they can detect.
• The cancer was aggressive, so we assume something would have happened over the last 8 months. Nope. 
• I have a meeting with Dr. Noonan next week and will ask her to explain. This will likely mean another 3-6 months of monitoring so see what, if anything, happens.

So that's the news today. Good news overall. I can get drugs to combat this lung infection, and the tumour isn't doing anything.

Other than pretty low energy, and this incessant cough, I'm feeling pretty good.