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98<br />
named after me) from Edmonton, my brother Jon, visiting from Gainesville Florida and my<br />
brother Robert, his daughter Andrea, her husband Ben, and granddaughter Alex.<br />
In addition, it will be my 45th medical class reunion and my 50th undergraduate reunion<br />
at McGill.<br />
These can not be missed.<br />
It seems like only yesterday, and yet also like an eternity ago when, on a visit to Montreal,<br />
I put my hand on a spot right in front of my ear and fount a mass. It was only 17 months<br />
ago. I have been through two major surgeries, 3 episodes of radiation treatments, 2<br />
courses of chemotherapy, a port insertion, innumerable blood draws, and about half a<br />
dozen sophisticated imaging studies. These are all further documented in my earlier blog<br />
posts.<br />
I continue to fight!<br />
Posted by David Shuster at 03:29PM (-07:00)<br />
Radiation Pneumonitis, No Evidence of<br />
<strong>Cancer</strong>!!!!!<br />
Friday, October 07, 2011<br />
Today I spoke <strong>with</strong> Dr. Nghiem. He told me that <strong>Merkel</strong> <strong>Cell</strong> Carcinoma looks like any<br />
other malignancy when it spreads to the lungs, round smooth nodules. It typically goes to<br />
the lungs only late in the disease when there is cancer which is widespread. He will look<br />
at the images on my last blog and have Dr, Parvathaneni look at them also and get back<br />
to me. I so much appreciate his responsiveness.<br />
I called Dr. Flam this morning and he agreed to see me on an urgent basis. I had labs<br />
done and my counts are improving. HGB is up to 12.3, WBC up to 5500. We did a<br />
baseline chest X-Ray and I must say that it looked almost normal. It amazes me how<br />
much more we see on a CT scan of the chest than on a routine X-Ray. We reviewed my<br />
PET/CT images. He examined me and I went for a walk while measuring my O2 Sat. This<br />
is a simple measurement <strong>with</strong> a device clipped to the finger which measures the<br />
percentage of oxygen in the blood compared to the maximum. It should run in the high<br />
90's. It was 95% at rest and on walking, went up to 97%. These results indicate good<br />
function.<br />
Dr. Flam has come to the conclusion that this is radiation pneumonitis, and the<br />
predominant area of involvement is the area which was irradiated. There are other areas<br />
involved also which he says is not uncommon. It is more common when chemotherapy is<br />
given at the same time as I had. The treatment if symptoms require it is <strong>with</strong> steroids. We<br />
would like to avoid steroids because of the immunosupressive effect which is not<br />
desirable <strong>with</strong> MCC.<br />
He is fine <strong>with</strong> me sticking <strong>with</strong> my plans to go to Montreal and I will bring pills for a<br />
course of steroids <strong>with</strong> me in case they are needed. He suggested I delay my flu shot<br />
until I get back but wants me to wear a mask on the airplanes.<br />
I have to thank Dr. Flam for seeing me in the middle of an exceedingly busy day.<br />
Bottom Line: No Evidence of <strong>Cancer</strong>. As good a result as I could hope for. Radiation<br />
Pneumonitis. A temporary inconvenience.<br />
On to Montreal.<br />
Posted by David Shuster at 02:53PM (-07:00)<br />
<strong>My</strong> <strong>Battle</strong> <strong>with</strong> <strong>Merkel</strong> <strong>Cell</strong> <strong>Cancer</strong>
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