Something Old, Something New
Well, the gastroenterologist saw cancer again (or still) in the esophagus. By his recollection, he thought it looked the same or maybe a little larger than when he did the same scoping procedure last February, but his actual measurements show it to be about a quarter inch smaller.
So, as planned, we’ve begun preparations for radiation treatment. I’ve been “modeled,” tattooed with tiny targets, and magic markered up with dotted lines. I look like one of those diagrams that show you where the flank steaks, prime rib, and sirloins come from. The actual radiation treatments won’t begin until the end of this month, but once they begin it will be five days a week for five weeks. Our insurer won’t cover the preferable proton therapy, so it will be traditional radiation.
I had yet another CT scan yesterday, our insurer having also denied coverage for the more revealing PET scan that both the oncologist and radiologist had requested. Given my symptoms, my oncologist Dr. Devore was somewhat surprised to again see no visible evidence of the cancer such as was clearly evident on my initial scan a year ago. No recurrence of the spot on the liver; no swollen lymph nodes (other than one suspicious pea-sized one that is still within what could pass for normal); no obvious thickening of the esophagus itself. Therefore, rather than change chemotherapies as recently planned for the course of the radiation treatments, he wants to continue the Herceptin-Xeloda regimen I’ve been on, unconvinced that it is no longer being effective. He insists that I am ahead of where I was a year ago, and if the current regimen will keep the cancer at bay for six or nine more months, that will be six or nine months of living with tolerable side effects. Plan B with the immunotherapy Keytruda is still in the bullpen, but all alternative treatments have their own potential side effects, which may render them useless in my case, such as what happened with the original chemotherapy of oxaliplatin, which near did me in last March-April.
Other than things directly related to my health and functioning, we are having insurance issues. The reason why my radiation treatments have not been actually scheduled is that the radiologist, Dr. Meek, is appealing the denial of the PET scan, which he still wants to target the treatment more accurately. They seem to think that they may be able to make the case for its needfulness still. In recent months, Medicare Part B began covering proton therapy, so I’ll be looking into expanding my Medicare coverage next week. Of course, we could just pay for the treatment without insurance, which would be $1,900 per day times 25 days! Hearing that almost gave me a heart attack – I wonder if that would count as another side effect? I don’t want to put off getting treated since I would like to start eating and swallowing more normally again, so Dr. Meek says we can start out with traditional radiation and switch over to proton if coverage can be obtained during the course of treatments.
Thanks for your continued prayers. I now I have been blessed mightily through them.