All recent scans are stable and unchanged. No signs of new metastatic disease. I get regular scans for my chest/abdomen (CT) and brain (MRI), both covered by insurance because they are considered standard of care given my history. It is true my doctor would rather I get PET/CT (whole body) instead of CT only, but the insurance company prefers CT only (they're cheaper) so that's what I get now.
There is an entire other area of these types of scans that insurance companies don't cover. That is when a healthy individual decides he or she wants to come in and get scanned, just for the heck of it. There are companies offering this service (I doubt my hospital would) so these are for the well-heeled. The idea is that this could proactively find disease. But it's controversial. Besides extra radiation exposure, there is also a risk of "overdiagnosis" if anything is seen. There can be false positives. And there can also be positive but clinically insignificant issues. Both scenarios could then lead to unnecessary additional procedures, e.g., follow-up scans or biopsies.
With that in mind, getting back to me, it's possible that my own regular scans could also pick up false positives or clinically insignificant positives (just like if I too was coming in "off the street" just to get scans "for the heck of it"). In particular, going back to my 2 most recent CT scans, the radiology reports also noted:
3/1/13:
It is also possible that one or both of these findings (if not cysts) could mean some disease might have reached those locations at some point. All lung lesions resolved in 2010 after IL-2 treatment, and had grown only very slowly up until then -- about 1mm every couple of months. But if any more disease (e.g., at the same time as the lung mets, or later in 2011 from hemorrhaging brain lesions) did make it to other parts of my body, it might also have been growing only very slowly, and if so, might have responded in the same way to IL-2 and/or Yervoy. And then later, might keep showing up on later radiology reports as unchanged and too small to characterize.
In any case, the continued remission in my lungs, at 3 years, is reaching into the "long tail" of IL-2's survival curve. Most cases in that statistical long tail are durable, long-term responses. I never envisioned being in that part of the curve when I hit the hospital bed for the first 2 cycles of IL-2 in May and June 2010. Knock on wood.
There is an entire other area of these types of scans that insurance companies don't cover. That is when a healthy individual decides he or she wants to come in and get scanned, just for the heck of it. There are companies offering this service (I doubt my hospital would) so these are for the well-heeled. The idea is that this could proactively find disease. But it's controversial. Besides extra radiation exposure, there is also a risk of "overdiagnosis" if anything is seen. There can be false positives. And there can also be positive but clinically insignificant issues. Both scenarios could then lead to unnecessary additional procedures, e.g., follow-up scans or biopsies.
With that in mind, getting back to me, it's possible that my own regular scans could also pick up false positives or clinically insignificant positives (just like if I too was coming in "off the street" just to get scans "for the heck of it"). In particular, going back to my 2 most recent CT scans, the radiology reports also noted:
3/1/13:
- Liver: Tiny subcentimeter segment 7 hypodensity is too small to characterize but unchanged. No suspicious hepatic lesion.
- Kidney: Tiny subcentimeter right renal hypodensities are too small to characterize but are statistically cysts.
- Liver: Tiny segment 7 hypodensity remains unchanged; too small to characterize.
- Kidney: Kidneys: Unchanged right renal hypodensities are too small to characterize.
It is also possible that one or both of these findings (if not cysts) could mean some disease might have reached those locations at some point. All lung lesions resolved in 2010 after IL-2 treatment, and had grown only very slowly up until then -- about 1mm every couple of months. But if any more disease (e.g., at the same time as the lung mets, or later in 2011 from hemorrhaging brain lesions) did make it to other parts of my body, it might also have been growing only very slowly, and if so, might have responded in the same way to IL-2 and/or Yervoy. And then later, might keep showing up on later radiology reports as unchanged and too small to characterize.
In any case, the continued remission in my lungs, at 3 years, is reaching into the "long tail" of IL-2's survival curve. Most cases in that statistical long tail are durable, long-term responses. I never envisioned being in that part of the curve when I hit the hospital bed for the first 2 cycles of IL-2 in May and June 2010. Knock on wood.
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