Enjoy: Unexpected news in an email
We received a remarkable email yesterday. It landed in Dena’s inbox, from Dr. Hammers, with the simple comment: “Enjoy!” It was like one of those emails that somebody sends with a joke that has been rounding the Internet for weeks. Good for a laugh … Thought you’d like this … Enjoy. But it wasn’t an inappropriate joke or a phishing scam — it was a copy of the radiology report from yesterday’s CT scan. The punchline surprised us nonetheless. It said: “Interval response to therapy with overall decrease in size of multiple bilateral lung masses.”
In other words: Your tumors are retreating, this drug is working.
We’d pulled out into the early morning darkness yesterday heading for Baltimore to meet with Dr. Hammers for a previously scheduled check-in. We had hot coffee, snow on the ground and no real expectations for the day other than undergoing routine bloodwork and holding a discussion with Dr. Hammers about my symptoms. He remained nervous about hemorrhaging in my lungs, and we were meeting every couple of weeks. There was no intention of doing a CT scan yesterday, but Dr. Hammers decided that he wanted to get a baseline scan in order to measure the effectiveness of the drug with another scan in a month or two.
I have more CT scans under my belt now than Manti T’eo has imaginary girlfriends, so what was one more? I hadn’t intended to even bother reading the scan, as we’d just had one a few weeks ago during my hospitalization New Year’s Day. Normally, scan days fuel extra anxiety, some anxious pacing, nervous jokes with Alice. Dena chews on Ativan like sunflower seeds. But this scan was just a baseline. No news to speak of. We’d save our anxiety for the next scan one to two months down the road.
So I needled up, stretched my arms over my head and lay silently while the machine snapped ghostly photographic slivers of my abdomen and chest. Afterwards, we didn’t even look back. Just walked out of the building and grabbed some lunch.
Some time later in the afternoon at home, Dena brought me her Blackberry and just handed it to me. I think she was hesitant to believe what she saw, so she didn’t say anything. I read through the CT scan report and stopped when I came to the section detailing my lung mets and their decrease in size compared to the scan from earlier this month. I re-read it. Then I continued. Was there a mistake? At the end of the report, the summary confirmed what I’d read: Interval response, overall decrease.
It took a moment to sink in because we’ve never, in the nearly four years of fighting cancer, had a CT scan that said simply: overall decrease. Even those scans that had shown some signs of hope, like the shrinkage of some lymph node mets while I was on Sutent, were inevitably marred with growth elsewhere.
I remain cautious. We have been on Cabo for less than a week. The reduction in tumor size is legitimate, but the scans still note “innumerable lung masses and nodules.” Maybe it’s four years of bad news. Maybe it’s that I know that none of these drugs are curative and that sooner or later they all stop working and I can’t know whether this may work for a month, a year, a week. Whether this reduction is all I get. Maybe it’s the lingering dark residue of the scenario presented just three weeks earlier while I was in the hospital, the one in which I did not survive the month to even try the new drug.
Still, the words “overall decrease” ring clear. They give hope. They are words we’ve never seen before on a scan, ever. And they leave us with faith that they will lead to even better news.
We plan to take Dr. Hammers’ simple but brilliant advice.