Tuesday, May 1, 2012

MRI's, the Bookends to my Chemo

My first MRI at the Dana Farber Cancer Institute (DFCI) was about nine weeks ago.  It was part of a whirlwind of activity that started when an astute doctor in the office of my now former specialist became aware of the results of my latest biopsy.  He contacted DFCI directly, and got the wheels in motion.  They responded quickly.  A short time later, I found myself in the office of an oncologist at Farber.  That was followed by the MRI, a battery of other tests, discussions about my choices for chemotherapy, an independent consult with a radiation oncologist, an eye-opening (in all the wrong ways) meeting with my now former specialist, decisions, and, on March 6th, the beginning of my first round of chemotherapy.  As I said, a whirlwind of activity.

The first MRI was an eye opener.  I was in the machine for 50 minutes.  The following morning, for my consult with the radiation oncologist, there were pictures.  In a way, it reminds me of the first time I saw an ultrasound -- it all seemed to be static at first but, slowly, the image came into focus.  As parents, the image of our unborn child was breathtaking, a moment of joy.  In this case, the oncologist showed us the image of my bladder.  At first, to me, it was nondescript.    It took a bit to  focus in, notice the shadows, and the disruptions on the inside of the bladder, and to realize that I was looking at the cancer and, inside my bladder, it seemed to be everywhere.  It was breathtaking, but not a moment of joy.  I started chemo less than a week later.

That was eight weeks ago.  It's been two weeks since the start of the fourth, and final, round of chemo.  As I'd learned to expect, the fourth round hit hardest.  By last Wednesday, I thought I had bottomed.  I was finally seeing/feeling "daylight", and some energy.  I thought that this part of my treatment was done!   Unfortunately, I went down hill on Thursday night.  I'd been short of breath for weeks, a symptom of being anemic.  By Friday morning, when I had an appointment for my "post chemo" MRI, walking even a few feet was a struggle.  I wanted to resist, but Fran was right to insist that I let her put me in a wheelchair for the walk to the MRI suite.  

From the MRI, she wheeled me to my oncologists office and they squeezed me into the morning schedule.  Blood labs quickly confirmed that I was severely (my words, not theirs) anemic.  My oncologist arranged for a transfusion, Friday afternoon, of two units of blood.   It has been all uphill from there -- my breathing today is better than it has been in weeks, as are my energy levels.    

With that, the "chemo chapter" of my treatment is over!  I now have three weeks in what I've been thinking about as the eye of the hurricane -- the chemo wall of the storm has passed, and I have this time to get stronger and prepare for the next part of treatment, my surgery.

In the meantime, what of that second bookend, the updated MRI?   While I haven't seen the pictures yet, the oncologist called us at home on Friday evening.  He wanted to check on how I was responding to the transfusions and to share the initial analysis of the MRI.  

Ultimately, my understanding is that the goal of my chemotherapy is something that we can't see -- it is to destroy any cancer cells, though still only microscopic, that may have already escaped the site of my cancer (the bladder).   Success at that goal, unfortunately, can't be confirmed with an MRI.  But, the MRI report was good -- still no measurable indications that the cancer has spread beyond the bladder, the walls of my bladder are in much better (i.e. smoother) condition than they were eight weeks ago, and the visible cancer in my bladder has been substantially reduced.  All things considered, it was a good a report as I could have hoped for!   And, well worth the price paid over the past eight weeks.

On a final note, it has also been about eight weeks since I wrote about crossing the PMC (Pan Mass Challenge) Bridge, the connector between the Yawkee Building at Dana Farber, where I am being treated, and the Dana Building, which houses the MRI suite.  I wrote at the time that, though I've pedaled well over 1,000 miles on the PMC bike ride, none were as difficult for me as that short walk over the PMC Bridge.   Little did I appreciate that my next journey over that short bridge, eight weeks later, would be in a wheelchair.   I look forward to walking over that bridge again and, ever more, to cycling again in a future PMC.


marc said...

What an incredible journey. Hang in there and always listen to Fran, you know she's right!

Lester said...

David... looking forward to the chapter you write after your next long bike ride!!! Stay strong!

cjgm2600 said...


Stay strong, we expect to see you in November in Israel. Continue on the road and I certainly hope you will be able to walk over that Hospital bridge in the near future and get on your bike and ride again.
Refuah Shalemah