The cease fire is over.
The few words on a sheet of white paper came off the page like cannon shots at some far away target, but they sounded like they were inside my head.
Joanie had the PET scan on February 14th, and a couple of days later I got the notes, and realized our lives were going to change once again.
In one short paragraph, the radiologist’s notes told us the cease fire was over, and the disease we thought had been hiding was back.
His notes said, “There is abnormal uptake seen involving the mid right pertracheal lymph nodes, a lower peritracheal lymph nodes, the indeterminant left upper lobe pulmonary nodule, and multiple right mid and lower ribs with adjacent abnormal soft tissue.” The “abnormal uptake” referred to the radio-active glucose showing up on the scan.
The radiologist’s impression was, “Changes worrisome for neoplasm involving some scattered mediastinal lymph nodes, the left upper lobe pulmonary nodule, and multiple mid and lower ribs with some associated abnormal soft tissue which accounts for the regions of soft tissue seen adjacent to the liver on correlated CT examination.”
As I understood what I was reading, the lymph nodes were in the central part of her chest, and the term “neoplasm” referred to abnormal soft tissue. Even I could understand what he meant when he mentioned rib involvement, and that scared me. That was as near as I could come, as a layman, to making sense of the notes I was looking at.
The bottom line was cancer was back, and it was as serious as it had ever been. This time, along with lymph node involvement, there were ribs involved. The soft tissue that was suspect on the CT scan was also confirmed to be cancerous, as was the left lung nodule.
At first, I didn’t know what to do with the information. Joanie had no idea of what the scan had shown. The news was devastating to me, I didn’t have the heart to tell her myself right then, so I took the coward’s way out and left the bad news to be delivered by a doctor.
What I did know was that we were dealing with recurrent disease, and all of the research and reading I had done since this thing started, was that there was no cure for recurrent, metastatic cervical cancer. Treatment regimens now are basically aimed at containing it, and keeping it from spreading.
Now that it was back for the fourth time, the situation was getting more serious than ever. On the the other hand, it is possible, I guess, it had never left, and had just been in hiding from the radiation and chemotherapy treatments Joanie had already undergone, and now found an opportunity to attack her again.
Dr. Carson’s words, when she told us that if the fluid on her lung was malignant, she would recommend the same chemotherapy protocol that had worked so well for Joanie in 2003, came back to me when I thought about what might be next. I didn’t know for sure what treatment she would recommend, but since Joanie had handled the treatment well in 2003, and it did do some good, they might try the same mix of chemo again. We would have to wait to hear from Dr. Carson before we would know.
We didn’t have to wait too long before Dr. Carson called to talk to Joanie. She had looked at the PET scan and the notes, and she told Joanie that the cancer, indeed, was back, and she was going to recommend the same treatment as before, when she was part of the clinical trial. She told Joanie the chemo could be done in Bismarck, and she would be contacting Dr. M. R. Thomas in the Hematolgy/Oncology department of Mid-Dakota Clinic to administer the treatments. The would be the same as they were before, and she expressed some optimism the outcome would be as favorable as it had in 2003.
The news threw Joanie for a loop. She looked at me after she was done talking to Carson, and asked me what I knew. I told her I had seen the notes, but I waited to talk to her about it until after she had heard from Carson to avoid any confusion that might be based on my own misreading of the results, or ignorance regarding what she would be recommending relative to chemotherapy.
As we sat there at the table in our small kitchen/dining area, I felt so sorry for her. She had a forlorn look on her face, that I hadn’t seen before in any of the other dark times. We just sat there for a few minutes, saying nothing. I couldn’t tell if this news was going to be a tipping point emotionally for her or not. She had already seen so many hopes dashed, so many disappointments, so much pain, I wondered if this was going to push her over the edge.
After another moment or two, as she looked at me with those brilliant blue eyes, a sad smile seemed to come to her face, and she said, “I guess it is a good thing we didn’t get rid of that wig.” Then she told me she was going to her office.
I knew then I didn’t have to worry, she was going to handle it