Holding steady

We traveled to Pittsburgh yesterday for my 3-month appointment. I had the CT scan done last week, and since my pulmonologist in State College ordered it, I could read the report online later that same day. So I knew ahead of time that the scan showed no change: the cancer isn't spreading, but it's not disappearing, either. Dr. Villaruz, my oncologist at UPMC, confirmed this and said that it's great news, that I look great, etc. 

Having no background in oncology, the radiologist who wrote the CT scan report noted "extensive emphysema." Dr. Villaruz explained that there are features of my lungs that often accompany emphysema, such as enlarged airways and pockets of air, and that there is also extensive scarring (fibrosis). This is why I still need to use oxygen while exercising. The scarring could be due to the cancer itself, the effects of a reaction to Tagrisso, the pneumonitis (inflammation) I had last summer, or ??? The only way to determine the cause is to do a bronchoscopy (lung biopsy). If I want this procedure, I need to ask my pulmonologist. Dr. Villaruz couldn't say -- and I don't think anyone can -- whether the scarring will improve over time or whether I've hit a plateau. Not knowing is hard. When I had the pulmonary emboli last summer and fall, I thought I would be off of oxygen once they resolved. Little did I know... I will ask my pulmonologist what he thinks about a bronchoscopy. It's an uncomplicated outpatient procedure (I've already had 3, I think), so I don't see a downside other than the (unknown) expense.

Coincidentally, my friend in State College who also has lung cancer and has the same primary care physician and oncologist had an appointment right after mine. We just missed seeing each other. 

The resident (?) assisting Dr. Villaruz was named Enrique. I asked what the university initials (UFPE) on his lab jacket stood for. Turns out he's from Brazil, so I mentioned that my colleague is currently in Brazil giving talks on her book about the Landless Workers' Movement. When we learned that he's from Recife, I told him that I teach a graduate class on Paulo Freire, who was from Recife and later did adult literacy work there. When he came back in the room, he informed us that he attends the same university where Freire taught law!

On our way back home, we stopped at our friend David's house for a lovely lunch. We'll return for another appointment in 3 months. The drive home was uneventful, unless you count seeing a Lily truck--our first such encounter.