Hurry Up And Wait

Last week, the day before Thanksgiving, I met with my radiation oncologist. The rise in PSA since the last treatment did not cause undue alarm. However, it’s likely that the disease has spread to other locations. Tomorrow I’ll have a PSMA PET/CT to look for those other locations. Small lesions on the femur and pelvis are suspects. The lesion on the spleen is probably something else. Future PC treatments will have to be hormones or drugs. Now that the cat is out of the bag the pinpoint radiation treatment will no longer be effective to contain the disease.

The doctor who treated my peritoneal mesothelioma in 2014 recently retired, so I met with his replacement yesterday to talk about the lesion on the spleen and what it’s cause might be. He said that there are many possibilities (some of them benign) and the return of mesothelioma is not a favored diagnosis, nor is PC. Tomorrow’s imaging study should show definitively whether the lesion is caused by PC. If not, his approach will be a very specific imaging test to better define the spleen problem. Unless something specific is discovered, the plan will be regular images to monitor the size of the lesion and the spleen. If it continues to grow then a biopsy is likely. Biopsy results would determine future actions. Interestingly, the doc described the spleen as a loose sack of hamburger. It’s highly vascular and a biopsy may cause bleeding that would require a surgical repair. If the lesion continues to expand, the risk is that it may rupture unexpectedly, which would require immediate attention due to the risk of bleeding out and dying.  

Summary: This is a step-by-step situation. I’m pleased that these doctors are in touch with each other and that all of them see all of the test results and images. I’ll post again when the PSMA PET/CT results are in.