To Quote Yosemite Sam...

"Blast it!"

Osteo-blast it, that is. It's all about my osteoblasts.

I told Dr. Schulz that I felt like I was back in middle school cuz all these terms were coming back to me from biology class. I learned a lot about my cancer in this 1 and 1/2 hour appointment today. (and here I thought it would be a quick in/quick out)

It's amazing how a bone scan is good for some things, and PET scans are good for other things, and MRIs are best used for some situations, and CT scans are best for other situations. It's like a game show...which scan has Carol NOT had done in the past three months? The answer is (D) CT scan. But it looks like I will probably have one done next week.

My cancer is not of the Lytic variety. That means it doesn't look like swiss cheese. It isn't "eating" away at the bones. The Zometa is intended to prevent lytic lesions. Instead, my cancer is osteoblastic, meaning my bones are growing in odd, bad ways. While it seems like this should mean I have more bone and they should be stronger, that is not the case. Bad bone growth weakens the bones.

What I also learned today, from my MRI, is that there are a LOT more spots than what we thought. Most of them are small, but quantity isn't good either. And, strangely enough, the left side appears worse than the right side, even though the PET scan shows the opposite and my only really sore spot is on my right.

Dr. Schulz feels that it's best if we do something sooner, rather than later, in terms of radiation. He wants to wait and talk to Dr Kumar on Monday, but he's leaning towards doing a CT scan next week from my breast bone to my knee caps. You see, there's even cancer in my femur bones that we didn't know about. The MRI films were very interesting to look at. It shows me in layers; one set layering me from top to bottom, and one layering me from back to front.

Radiation options are as follows:
1. radiate everything all at once, which can drastically lower my blood cell counts and cause greater discomfort (gee, that doesn't sound like much of an option)
2. radiate one half of me, take a month or so off to allow for recovery, and then radiate the other half (maybe more tolerable?)
3. do a one-time intravenous radiation dose at the hospital, which could drop my blood cells significantly, but because there are so many spots in so many places it might be the most all-inclusive

Dr Schulz knows we're going to Mexico in March. We may or may not start radiation before the trip. He would hate for me to fracture something while south of the border. It would spoil our vacation, to be sure, and where would I go for treatment? We debated which of those two concerns would be the greater!

Nothing has been decided at this point. Like I said, Dr S and Dr K need to consult on Monday. I will hear back from Dr S either late Monday or on Tuesday. I feel like radiation is a "good" option for me. Yes, my symptoms are extremely limited right now, but I can't help but wonder where I'd be now if we hadn't done something to treat my mostly asymptomatic neck, back in 2004. And as Dr Schulz said...we would hate to have something fracture, need to have surgery done to put in a stabilizer of some sort, go through recovery time, and then do radiation. Hopefully, by doing radiation now, we can avoid a fracture in the first place.

Does all of this make sense to everyone? Oddly enough, the appointment was quite fascinating. Dr Schulz is an intelligent man and covered all areas of concern with me. It did seem like we were discussing someone else, or like it was a classroom situation though. I think I'm ok with all of this. I don't feel panicked or freaked out in the least. Maybe because this feels like an "active" approach? (but wait, we weren't going to focus on that anymore, were we!)

Blast the Osteoblasts with Radiation, I say!