Some more radiation...

On my last CT scan, we were very happy to see that my lungs looked quite good.  Unfortunately, we did see new nodules in my liver.  While we did not biopsy these lesions, their appearance - together with my history - certainly suggests that they're from my cancer.

You'll recall that I had whole-lung radiation in August (we treated my entire lung fields, from my neck down to mid abdomen).  Because the diaphragm is domed, the right lung drapes over a portion of the liver.  As a result, when we were treating my lungs with radiation, the upper half of my liver also was irradiated.

Interestingly, my liver lesions appear to be in the low part of the liver, the portion that was not irradiated.  So, there is some circumstantial evidence that radiation helps to control my tumor (otherwise, we would expect these lesions to be more widely distributed throughout the liver).

After talking with my doctors at Hopkins and elsewhere, we've decided to pursue a course of whole-liver radiation.  While this is not a typical radiation treatment, it's not unheard of and - in my case - I think that we have a sound rationale for choosing it.

I'll start treatment on Monday and continue for about 2 weeks.  We don't expect major side effects during treatment (I'll likely have some fatigue and mild irritation of my stomach).  Importantly, we've chosen a radiation dose that will minimize the chance of serious liver or lung damage following my treatment.

Certainly, we're still concerned about disease that might be elsewhere in my body (even though there's nothing that we can see on imaging).  We'll likely start a drug to address this concern after my liver radiation is completed.

As always, we really do appreciate your prayers and support - thank you again,
Robert and Gwyneth

PS: William has a really terrific Halloween costume for today (made by Gwyneth!!) - we'll post pictures soon!