Column: In Contrast

Commentary

Even though my previous CT Scan “looked good,” nonetheless I am already, two months out, thinking about my next scan, scheduled for July 15. I am not nervous or anxious about it yet. But I am something. Typically, those emotions begin a week or so before the scan and last a week or so after, until we learn the results. What I am addressing in my own way, is what challenges some cancer patients, certainly me: we can’t leave well enough alone and, as a related condition, might not savor the moment/good news because the underlying diagnosis – in my case, non-small cell lung cancer, stage IV – is so bad, and by bad I mean incurable. In fact, that was the first thing I remember my oncologist saying to me/Team Lourie: “I can treat you but I can’t cure you.”

Nevertheless, here I am six-plus years later, alive and abnormally well, given my original prognosis: “13 months to two years.” Still undergoing chemotherapy, still not cured; characterized by my oncologist as his “third miracle.” As I wait for the other shoe to drop, other than experiencing symptoms – which I rarely have – and evaluating my every-three-week pre-chemotherapy lab work, the diagnostic scans (CT Scan for me mostly, occasionally an MRI or a bone scan) are the best indicators of tumor growth, movement and/or new activity. To get the clearest radiological picture/assessment, often a dye (a.k.a “contrast”) is injected into the patient to provide the computerized tomography what it needs to create a more detailed rendering of the affected area. Given my preexisting, chemotherapy-affected kidney damage, and factoring in that the “contrast” would be filtered through the kidneys, causing potential stress to that organ, per doctor’s orders (or lack thereof), I’ve not had a CT Scan with contrast for three or four years (and I usually have four CT Scans per year).

However safe he/we have been, neither my oncologist nor I are the least bit sorry about it. He has been able to reasonably track the tumors in my lungs; and so far, so good (amazing, actually). But, for the next scan, he has ordered that it be completed with contrast. When I asked him why now/what about my elevated creatinine/kidney function, his answer was something about my levels being higher than normal but not trending up, so, since it’s been years, he thought it prudent – and timely, all things considered – to proceed. Seemed reasonable, so I consented; so “contrasting” we shall go.

I can’t imagine there will be confirmation that all is indeed well and what the oncologist initially feared was trouble two months ago will be even less of a concern than he expressed two weeks ago when we last met and discussed the findings of this most recent scan. But what do I know? Certainly it’s possible. I’m living proof of that. Still, this next scan/result is two months away. I shouldn’t even be thinking about it now. I should be enjoying the positive findings of my last scan, not anticipating what could possibly be worse with the next one. But I am. 

This is the life, albeit an extremely lucky one, of a “terminal” cancer patient (this one, anyway). I want to live for today but it’s hard not to worry about tomorrow.