Thursday, October 02, 2008

October 1, 2008 - Stable Is Good

“Everything looks pretty stable.” That’s Dr. Lerner’s assessment of my recent PET and CT scan results, as we meet together for an examination this afternoon. He delivers the news in his best physician deadpan style, one I’ve grown used to over the course of our many consultations.

The doctor goes on to explain that the areas that were lighting up near my neck on my earlier PET scan are no longer lighting up on this recent one, and that there’s a small, new area lighting up on my lower back. “The problem with PET scans,” he quickly adds, “is that there are a lot of false positives – these areas are pretty small, so they could be nothing.”

They all look fine on the CT scan, he continues.

I ask about my residual abdominal mass that had measured 17% larger on my last CT scan – a measurement Dr. Lerner figured at the time could still be within the statistical margin of error (it seems the radiologists don’t start getting alarmed until such a mass shows 25% enlargement). It doesn’t look any bigger at all, on this most recent scan.

Round about this time the phone rings. Dr. Lerner apologizes for the interruption, then takes the call. It’s evidently from another doctor who wants to confer about a patient. The receptionist brings in a thick file, and Dr. Lerner spends 3 or 4 minutes sharing details similar to my own case – something about the growth rate of certain tumors, I can’t follow it all. After hanging up, he comments, “It’s nice to be able to tell someone good news for a change.”

“I guess my test results are good news, right?”

“Yes, they are,” he replies, “for your situation.”

It’s not exactly a ringing endorsement – and it’s delivered in that same deadpan style, friendly but not overly cheerful – but I’ll take it. What I think the doctor means by that last qualifier – “for your situation” – is that, with an indolent lymphoma no one looks for cure, only stability.

Stable is good. Guess I’ll watch and wait some more.


Stushie said...

Sounds good, Carl. May it continue to be so.

Ronni Gordon said...

I hesitate to comment because you seem to be OK with the doctor's comment that the results are good "for your situation." It struck a chord for me and made me think about recent postings on Wendy Harpman's site about doctor empathy. I don't think they know how carefully patients listen to every word. I don't really "know" you, but your doctor's comment upset me. I wish he had just plain said that yes, your results are good. The rest of the sentence is not needed. Everyone's results are good or bad for their own situation! No need to stick in the modifier. In any case, I wish you continued health and stability!

Carl said...


I take no offense at his comment because, based on other conversations we've had, I'm well aware that indolent (follicular) lymphoma is unlike many other cancers.

It's considered "incurable but treatable." That means that, ultimately, there's no completely good news to be had, because the cancer's going to come back eventually, even if one set of scans comes back showing no growth of the disease.

The only treatment that's potentially curative is a allogeneic stem-cell transplant, and my condition isn't serious enough yet to face that difficult process, with its attendant risks.

The news the doctor told me is the best I could have hoped for, under the circumstances: no measurable growth. Yet, the cancer's still there, slowly growing in fits and starts. Eventually I'm going to see scan results showing that it's definitely grown, and sometime after that, another set of results indicating that I have to begin treatment.

Dr. Lerner wants to make sure I have no illusions about that. I don't hold it against him.

Ronni Gordon said...

Hi again,

Thanks for the info. I didn't know all the background; now I get it. Sounds like you have a lot of good options!