Let's Be Negative ... It's OK

Where cancer is concerned, good news can wait, but bad news won't. There's good news on the horizon, however, for cancer patients who just can't wait to know the progress of their treatments.

I wasn't sure how to answer the nurse's question, with my stomach tied in knots for the past week.

"How are you feeling?"

It's a very simple question, but it hardly seemed innocent given that I was waiting to hear whether or not my cancer had come back.

"More or less OK, except for a cold," but in truth I was tired, on edge and feeling some abdominal pain.

Those symptoms started to vanish with one word: "Negative." The test results of my latest Octreotide scan at Stanford Medical Center were negative, according to the nurse. Even better, I don't need another such scan for another year, according to Doctor Jeffrey Norton.

The test was a three-day ordeal, although Stanford's Nuclear medicine lab is actually very comfortable. After all the driving, the early hours, the waiting and the worrying, I should take my wife Tracy to Hawaii as a reward for our success.

In the meantime, Tracy and I had to celebrate with our friends at La Ginestra to deliver the news to them personally. I'll tell you, food rarely tasted so wonderful. My appetite returned and I savored the ravioli like life itself.

And thanks to our dear friend Lucia, we'll never doubt the power of Italian prayers.

I'll take any little victory where I can get them — but this feels like I just won the biggest fight of my life. I realize, in fact, that this is just one round in a very long fight with my carcinoid cancer, but it feels so good.

This is not the end. I'll still keep my appointment with the nurses at the Marin Cancer Institute on Thursday for my monthly Sandostatin injection. I also have to go back to Stanford in a few weeks for a bone scan.

As I was cautioned by one of Stanford's Nuclear Medicine technicians, although these scans are very advanced and quite accurate, they are not necessarily comprehensive. If we look in the wrong area, we might still miss the cancer.

For now, I'm quite happy to accept that the cancer is being held in check by the Sandostatin LAR.

There is hope coming out of Stanford for impatient patients. And believe me, it's hard to be patient with cancer. Dean Felsher, MD, PhD, and David Palk, PhD, work in the Cancer Institute, but they could be quite at home in the math department as well. The doctors seem to have developed a mathematical equation to predict earlier the possible success of certain cancer treatments.

The following was written by Krista Conger in an article that appeared on the Stanford website:
Felsher and his colleagues used a computational biology approach to characterize a phenomenon called oncogene addiction, in which a cancer is dependent on the activity of one cancer-causing gene. Tumors that are dependent on a single mutated protein for their growth regress quickly when the activity of that protein, or oncogene, is blocked. However, because individual cancers reflect the interplay of hundreds or thousands of mutations within each cell, it’s very difficult to tell which, or how many, tumors fall into that category.

“Lots of people will respond to therapy at first, but many times they don’t get better,” said Felsher. “With a new therapy, would you rather wait four months and say, ‘Well, it’s kind of working,’ or is it better to know after a couple of weeks? We’ve found that the kinetics of regression can quickly predict whether the tumor is oncogene-addicted and likely to be treated successfully by targeted therapies.”

Hopefully, the wait is almost over for all of us, with only good news to come.

For more information on cancer and carcinoid cancer, consider these sites:

Carcinoid Cancer Foundation

Caring for Carcinoid Foundation

Carcinoid Cancer Awareness Network


Stanford Medicine Cancer Institute

Cedars-Sinai Hospital, Los Angeles

Marin Cancer Institute

University Hospital, Basel, Switzerland

Jimmy V Foundation

American Cancer Society

Lucy Wiley January 31, 2012 at 03:45 AM
I want to know more about the mathematical prognosis work. Thanks for putting it out there. BTW: the radiology tech is correct - Oscan doesn't reveal all tumors in all patients.


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