Unhappy Doctor

Barb and I felt pretty good going into the appointment with the oncologist yesterday morning. We expected to discuss my PET scan results from Wednesday. And like always I had a few side effect issues I wanted to discuss with him.

We were very positive an upbeat. Afterall, what could the PET scan tell me that I didn't already know? I certainly already knew I had cancer. And I already knew the cancer had spread all over. So, how bad could it be? If anything, we figured it could only be good news.

But as soon as the oncologist entered we could tell that he wasn't happy. One of the first things he said to us, after a little small talk, was "I'm not very happy about these PET scan results."

That threw us for a bit of a loop. That was the start of our confusion.

One of the things that I don't like about our healthcare system is the little amount of time you get to spend with a doctor. Doctors are on rigid schedules and plan out appointments in 15-minute increments. That's not much time.

My oncologist does come prepared for appointments, which I appreciate. But being prepared he also had a pre-set agenda, which pretty much took up our entire 15-minutes. It was kind of like bombarding us with his perspective and then sending us home with our heads whirling about with all the information we just tried to digest.

Barb and I drove home yesterday relatively confused.

In my oncologist's defense, he has given me his cell phone number and he does welcome my calls (I've used it only twice). And yesterday, upon leaving, he did say, "If you want to talk some more give me a call."

The PET scan shows any areas of high metabolic activity in the body. So by the nature of it, it will show more than a normal CT scan.

The oncologist felt that the PET scan had shown further spread of the cancer, enough so that he felt it was time to switch to a different chemotherapy.

I was OK with this because this chemo had been going for about six-months and that is about the expected time for the chemo to work before failiing.

But I wasn't as convinced over his reasoning. A lot of things that the PET scan showed were not new tumors but areas of general activity that the PET scan would have picked up and traditional CT scans would not.

The oncologist questioned me thoroughly about my lungs and my breathing. I've had no trouble with either. He inspected me closely, listened closely to my lungs, and there were no problems.

The oncologist had me undress and he did a thorough inspection of my buttocks.

Confused, he finally explained to me that the PET scan showed activity along the lining of my lungs, and the surface of my buttocks. He almost seemed disappointed that he didn't find any evidence of anything in either area.

He barely touched on a lot of the good news: there was activity in the liver before and now there was none; there was activity in the kidney before and now there was none; there was activity in my right hip bone and now there was none.

All in all, I take this as a "push." There was possibly some bad, but certainly some good. I'm still feeling good. And I'm OK with switching up chemos. Some of the best results I have had from chemotherapy have come from transitions from one type of chemo to another.

There is work to do. I've acquired a copy of the PET scan report and have been able to study it. I want to see if a traditional CT report also accompanies this. That will tell me a lot more about the lungs.

We also have to pursue the activity in the brain, and the potential successes of my last radiation treatment. I have an MRI scan of the brain scheduled for early Monday morning.

I'll meet with the oncologist again in the first week of August, as well as the neurologist.

The new chemo is not a pill but an IV administered at the health campus. I'll have to have the IV for two-hours one day every other week.

My approach today is no different than yesterday or the day before. As unhappy as the doc was over the PET scan results, I just can't justify it and feel that he may be over reacting a little.

As Barb said, "We'll just have to do daily butt inspections."