Test results

I've been a nervous wreck for the past few days waiting on the results of Mike's CT scan. And for good reason, apparently. The cancer is "a little bit worse." That 's a quote from Mike's doctor and not one we wanted to hear.

The tumor in his neck that we can see is pretty much the same, even after shrinking somewhat initially. There's one new small spot in his neck. Another lymph node in his neck has actually improved. One spot in the middle of his chest has grown and another has formed.

In addition to the scan, some other tests were run to again try to find the origin of this cancer. I mentioned before that an assay showed it was coming from the lungs. A new look at some cells also pointed to the lung -- small-cell carcinoma. This is apparently the kind of cancer that smokers get. Dr. Neel's words to Mike: you should not have this. He says it's bizarre to see in a non-smoker.

Nonetheless, if there's a silver lining, it's that we're narrowing in on what this cancer is. Right now, he still defines it as carcinoma of unknown primary but added "favoring small-cell lung cancer." Knowing what it is means knowing how to treat it. Up until now, Dr. Neel says we've really just been taking shots in the dark.

So there will be a change in chemo. We're not sure of the specifics right now. We do know that Mike won't have to have Erbitux anymore. That's the one he had to have every week. So he's kind of relieved to get a break. Dr. Neel had just received the test results hours before our appointment so he wasn't 100 percent sure what he wanted to do on the chemo. He's going to study it some more -- apparently Mike's case is somewhat of a medical mystery -- and consult with the other oncologists in the practice. We see him again on Aug. 12 and the new chemo will start that day too.

The drug that's most commonly used to treat this is Cisplatin, which he's been getting. Why hasn't it worked? Perhaps because it's not in the proper combination with other drugs. So Neel is trying to determine which one to use.

Small-cell lung cancer, like carcinoma of unknown primary, isn't curable. It spreads fast, but can die fast with chemo. The goal is to shrink the tumors. What generally happens then, is a patient can go months, maybe a year or so, before it reappears. Then chemo starts again.

So we've got a long road ahead of us.