Hey again. It's been about 3 months which means new scan results. But before I get into that, a quick story about my teeth.  About 3 weeks ago I started having a lot of sensitivity and some pain in one of my top teeth (upper left bicuspid, #13 for those who want to know). I went to the dentist and it was determined I either needed a root canal or an extraction. However, after talking with my oncologist it was determined that I would have to be off of my immunotherapy (which we believe is allowing the chemo to be most effective) for 6-9 months. 3 months before the dental procedure, and at least three months after but it could be longer depending on how well my bone healed. Ramucirumab, my immunotherapy, is well known to contribute to a condition called Osteonecrosis of the jaw. AKA: your jaw bone starts to die and decay from the site of trauma into healthy bone. It's very difficult to treat under the best circumstances, and, of course, I am not in the best circumstances. So, I started doing some research into absolutely anything else I could do and I found a toothpaste that claimed to heal superficial cavities. Now since I need a root canal my cavity isn't superficial, but I thought that maybe I can at least stop it from getting worse. And it seems I have. Now three weeks after that dental appointment I still have some sensitivity and little to no pain. This kind of amazed my oncology team, but we're all happy about it. Praying that the tooth continues to improve or at least not get worse so I don't get into a position where I have to have it pulled.

Now onto the scan results. I had an MRI on 4/12, and yet again my brain is unremarkable. I love that word in scan results. My CT, the one that probably matters the most, was on 4/15. The CT comes back as two separate reports, one for my chest, one for my abdomen/pelvis. So The chest results first: These results were a little hard to interpret the specifics of (as my mother-in-law said "punctuation is important"), but the words improved and improving were used a lot. So when we received the results on Monday, we were feeling pretty good about it but still wanting to talk to my oncologist to be sure. Then we got the abdomen/pelvis results. I've had a "lytic lesion" on my right hip bone since the very first scan in August '22. Follow up PET and Bone Scans didn't show that this lesion was anything cancerous and we found out that a lot of women who have had children have similar benign lesions. This most recent scan described the lesion as having a slow progressive increase in size and being "now with permeative cortical destruction and aggressive periosteal reaction". Those words basically meant nothing to me, but the last sentence of the report definitely meant a lot. "While this may represent a metastatic lesion, a 2nd primary malignancy such as osteosarcoma or Ewing's sarcoma should also be considered."  Scary! Now I couldn't wait to talk to my oncologist, but it was 5:30pm so I knew that would have to wait till morning.

Luckily, I went back about an hour later to re-read that report and saw a note from my oncologist to the PA I'll be seeing on Wednesday (4/17). He asked her to talk to me about a bone biopsy and a referral to radiation oncology AND that my disease is otherwise stable. I felt a lot better. There was a plan coming together and it looked like we were going to confirm what's going on with my hip and then zap it. So I'll get to stay on my current treatment plan which seems to be working well. My appointment with the PA on Wednesday confirmed that plan of action. I don't have to go off my immunotherapy for the bone biopsy, which is surprising, but a good thing. They were also very surprised, but encouraged, that I'm not having any pain with this bone lesion. One of the hallmarks of most bone cancers is severe pain. So the fact that I'm not having any is either a good thing or very atypical. I have consults with radiation oncology and interventional radiology next week and as soon as the biopsy is done I can start radiation. 

Chuck and Beth Ann will be headed out after Memorial Day, so my mom will be taking over helping me recover after chemo. It's been such a blessing having them here for so long. They've really gone out of their way (though they would deny that) to be available to help us and I couldn't ask for better in-laws. And of course Zooey has loved seeing Grandma and Pop-Pop so often.  As far as help we need right now; we may be needing some more help with child care here and there, but we'll post what we need when we need it. We've been really blessed by so many people and our church; helping and praying and being there for us in every way we could ask. And my care team is great. My oncologist, Dr. Abdulkareem and his PA Caitlyn, my nurse navigator Amy Jo, Dr. Birkenstock, my radiology oncologist, all of the nurses and aids at ABBCI. Everyone we've met through this process has been really encouraging and really good at their jobs. Anthony always semi-jokes that oncology must poach the best of the best from all the other departments, and he's not wrong.  I will be very sad to leave ABBCI if it ever comes to that, not saying it will, but you never know what the future may bring.  Specific prayer requests right now: Wisdom, lots and lots of wisdom. For us and the doctors to decide on the best course of action. Peace, for me especially. Cancer is stressful, in case you didn't know, and I'm already a high-anxiety person so it gets way worse around scan time. Anthony's my solid ground, he never lets his stress show and he's always just thinking about the next step. Not the 10th step, just the very next one, and I need that. 

Oh and healing, always for healing.

25 total rounds of chemo so far: 15 rounds of treatment #1, going into round 10 of treatment #2. 

10 rounds of radiation with some number soon to come.