Tuesday, January 7, 2020

When "No Evidence" Is a Very Good Thing!


Reader's alert:  This is a long and technical post. The bottom line is that the scan looks good on initial report.  Boom.

Brain cancer is...

 ...presenting "no evidence." 

Darrell was a champ for today's scan.  It went smoothly, and we were out of the Cancer Center with MRI discs in hand by 9:15 a.m.

The radiologist's report (above) was released this afternoon.  The initial news is great!

Here's a primer on reading Darrell's GBM MRI reports, in case people would like a refresher.

  1. After Darrell's scan, a radiologist on staff reads the images and compares them with past images.
  2. The radiologist writes a report, which gets posted to Darrell's internal records, and then Dr. Park (his oncologist) releases the report to the patient portal where Darrell can see it.
  3. The report has two parts:  comments and impression.  Comments are like "findings," and the impression (above) is like "conclusions" that the radiologist draws from the findings.
  4. GBM currently has no cure, and there is no way to confirm its presence or absence other than taking brain samples--which for obvious reasons only happens when necessitated by likely cancer growth.  The best that physicians can do is to take and study brain images and make best guesses about the likelihood that the cancer is recurring or growing.  Radiologists need to admit the possibility that the cancer could be tiny, or that they might misinterpret what they see in the images. Thus, the best news to receive in a GBM scan is that there is "no evidence" of growth. Doctors  can't say that the cancer is gone, only that they can find no visual evidence of its current existence. 
  5. That's the great news we got today in the initial report.  Specifically, from above:  
    1. #1 means that the radiologist could today see (as all past scans have shown) that Darrell's brain was changed by the 2016 surgery. 
    2.  #2 means that the radiologist couldn't see any clear evidence that there is tumor left or that any tumor is growing.  
    3. #3 means that the radiologist could also not see that any other funky, disagreeable thing (such as tissue death, bleeding, or swelling) is occurring in Darrell's brain.
Today's scan results are an example of when "no evidence" is a very good thing indeed!

Here! Here!  Darrell is so relieved.  At dinner, he reflected that these results make him appreciate anew both what we have gone through (really, what he has gone through) and all we have today.

Here are some moments he appreciated today:

Entering "Permanent Invisibility World" (We finally used up all the white arrays.)




Celebratory Tuna Sandwich

Yet Another Opportunity to Walk this Beautiful Earth

Today's initial report of Darrell's clear scan is, very sadly, contrasted with the news that a dear friend and colleague recently died after a private battle with cancer. Our friend was diagnosed after Darrell and left this earth before us. What a horrible loss for our world.

(On the day we lit candles for newly diagnosed loved ones in 2016, we lit a candle for this friend; here's a link to the candle lighting post.)  

Team D., please let it never take a clear brain cancer scan for me to appreciate our world and every single wonderful person and thing in it.

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