A Magnificent Response

As the title of this post suggests, it’s been a great past few days. On Thursday, June 1 I underwent a CT scan and visited with the doctor to review the results.

I am ecstatic to report that the results were nothing short of amazing. Our doctor said that this was the best CT scan after only 3 rounds of treatment he has ever seen. Tumor shrinkage of over 50% was observed throughout the majority of tumors. This degree of shrinkage is rarely seen this early in the treatment schedule. I have summarized some of the details provided from the CT scan pathology report.  

•     The 3.4 centimeter tumor in my right lung has now been reduced by approximately 50%.
•     At initial diagnosis many of the lymph nodes throughout my chest were significantly enlarged Many of them now normal sized and the ones that are still enlarged are significantly smaller.
•     My heart has reduced in size by 2 centimeters. At initial diagnosis my heart was enlarged from swelling which can be attributed to the fluid and the close proximity of tumors. The heart returning to normal size shows that my body is recovering from the damage left by the aggressive cancer.
•     Numerous tumors throughout other parts of the chest and lung were either smaller or gone.
•     There is no evidence of the cancer spreading to any other parts of my body.

Going into the test I felt confident that the results were going to be positive, but I really wasn’t sure how good. My doctor was prepared to see the tumors increase in size as a result of the immune response. No one expected the immune response to be this powerful this early in treatment. My doctor said that it is likely the tumors are even smaller than what the CT scan displayed, primarily due to the T cells attached to the tumors. Additionally, when there is a response this quickly and dramatic, it is possible that some of the tumors showing up are partially comprised of dead cancer cell tissue.

There will be no change in my treatment plan. I received the fourth round of treatment after the appointment on Thursday. I will be undergoing another CT scan in another 9 weeks after I have completed the 6th round of treatment. However, I do plan to make some minor lifestyle changes to compensate for the increased fatigue I’ve been experiencing. Since my immune system has been performing at an insane level to shrink the tumors, additional fatigue is to be expected. This is a side effect I will gladly accept.

Since my cancer is stage 4, it is not medically possible to be “cured.” However, it is possible to have a complete response, meaning that the cancer goes away completely and tests show no evidence of disease. If that happens, which I am certainly praying and hoping for, the next milestone would be the duration of the response. The response in which cancer does not return could be anywhere from a few months to a permanent response in which the cancer never returns. It is very rare for someone with stage 4 lung cancer to have a permanent response. However, immunotherapy drugs are starting to lengthen the responses because the drugs help train the immune system to recognize and fight cancer cells even after treatment stops. My doctor said that there isn’t enough research with Keytruda to accurately estimate a response time, but having a dramatic and quick response is very encouraging.

Not only is treatment working, but the prayers and support provided by everyone is playing a significant role. I cannot thank everyone enough. I keep saying that everything is going as good as I could possibly expect; and I pray that it continues. Despite the progress made, I still have a long way to go, but Maureen and I have renewed confidence in winning this fight.

I expect to publish 1-2 blog posts over the next 9 weeks leading up to the next CT scan.