These last few weeks have been horrible, informative, and whatever the heck is the opposite of fun. I’m frankly a little depressed and discouraged as I hope to explain below.
The fluid in the lungs is back. It is not as bad as it was before it was drained in the hospital, but it is definitely returning. Even a dumb guy like me could clearly see the horizontal line showing the liquid level on the X-ray a few days ago. The pathology on the liquid came back as positive for cancer which was no surprise.
Today was yet another CT scan of the chest. I think this is the third one in two weeks. It is clear to me that the doctors are expecting to find cancer in the tissue surrounding the chest cavity. The write-up of the CT scan seemed to confirm that without coming right out and saying it.
Below are some of the medical terms used in the write-up
Ill defined/irregular pulmonary nodules
Nodules in the lungs are not necessarily cancer but could be. Given everything else happening, nobody is even suggesting that they be tested. It’s pointless.
Multiple enlarged mediastinal lymph nodes
When the lymph nodes in the mediastinum become enlarged, it is called mediastinal lymphadenopathy. Mediastinal lymph node enlargement can occur from a wide range of diseases, either on its own or in association with other lung conditions. It usually stays less than 10 mm in diameter.
Mediastinal lymph nodes are typically the first ones that cancer cells from the lungs will trap, providing doctors have the means to know if cancer is spreading.
Under the heading Impressions
Recurrent pleural collection
Pleural effusion, which some people call “water on the lungs,” is the buildup of excess fluid between the layers of the pleura outside your lungs. The pleura are thin membranes that line your lungs and the inside of your chest cavity.
Interlobular septal thickening and may be due to edema or lymphangitic carcinomatosis
Interlobular septal thickening is commonly seen in patients with interstitial lung disease. On HRCT, numerous clearly visible septal lines usually indicates the presence of some interstitial abnormality. Septal thickening can be definied as being either smooth, nodular or irregular and each likely represents a different pathologic process.
(The above URL links to an example of Interlobular septal thickening.)
Lymphangitis carcinomatosis is the malignant infiltration and inflammation of lymphatic vessels secondary to the metastatic spread of malignancy from a primary site. The carcinomatous infiltration of the lymphatic vessels almost always occurs in the pulmonary interstitial lymphatics
The quotes below are in the linked study under the heading “Prognosis”
Diagnosis of pulmonary lymphangitic carcinomatosis is considered to represent end-stage malignancy, with the life expectancy being about six months.
Bruce et al. observed death within three months of presentation of respiratory symptoms in half of the patients, and Zhang et al. noted that almost 72% of the patients died within seven months of presentation.
Folks, this diagnosis is eerily similar to the cancer that took out my wife’s mother about ten years ago. My wife’s disease is above the diaphragm while her mother’s cancer was below. Both are lethal.
However, this is not all the cancer news for the week.
As stated in a previous post, the cancerous cyst that was removed in November grew back in short order and is now larger than its predecessor. It was supposed to be removed this week via an outpatient procedure but after taking one look at it, the doctor said it was too big and would need to be removed in the hospital operating room. This is scheduled for next week.
Also, it has been agreed that my wife will be getting a stint in her esophagus at the end of the month. This is intended to hold her esophagus open to the max that it currently opens which is about 12 millimeters. Hopefully this will allow her to eat more solid types of food. Poached eggs are a rather boring breakfast every day.
The thought that my wife could have as little as three months is very disturbing. I thought we would have more time together. What is happening to her respiratory system looks to be the beginning of a cascading failure of bodily systems.
I feel especially sad for the children. They kind of know what’s going to happen to their mother but…