A Provisional Diagnosis
A lot sure changes in a couple days. We saw my local oncologist today and I now have a provisional diagnosis and a treatment plan: high grade metastatic thyroid cancer of the lungs with a BRAF-600 mutation. It is technically not anaplastic thyroid cancer but that may be a diagnostic distinction without a difference. It is definitely not papillary thyroid cancer, which is what I did have. The cells look and behave differently. There is one more advanced genetic test from which we should get results in about 10 days which could change things. But for now that’s what it is.
Since last Friday I have been taking two new (to me) cancer drugs: dabrafenib and tremetinib. They think I have been responding well to those. Thank you lenvantinib for your 5.5 years of service, but you are done.
So the treatment plan is as follows: keep me on those, (doctors) read the report in 10 days and see if that changes anything, CT scan in 4-6 weeks. For now, no IV chemo or immunotherapy. That’s the next option if the d&t treatment doesn’t work or if there is another malignant
Dr Seuss Presents the PleurX
Yesterday I had a PleurX installed in my left lung. It’s a clever little drainage system that allows me to drain my pleural effusion outpatient rather than come in. The expectation is that my lungs will make less and less fluid over time with treatment and I will get it taken out in 1-3 months. the surgery itself was painless, but the unfurling of the lung is painful after the initial drainage so I spent a good chunk of the last 24 hours on Dilaudid. I also have a PICC (peripheral insertion central catheter) on my right side
Discharge Date
We are realistically looking at Monday or Tuesday because many things don’t really happen here on the weekend. There are some logistics like PleurX training; seeing if I can sleep flat or need a bed wedge at home (will try flat tonight), and doing my PT exercises which now include stairs to recondition me after this very sedentary (but restful) period in the hospital.
What all this means
I’m going to leave M or T with a lot of uncertainty. Nobody knows if this treatment will work. I expect the first few days at home will be challenging on their own, but then it will get easier and I’ll be able to start enjoying more of my sabbatical again, which is my most immediate goal.