Updated: Sep 30, 2020
David got his 15th IV of the Keytruda immunotherapy drug on Sept. 24, and we received good news regarding his recent brain MRI. There continue to be no new brain tumors, and the two largest ones in the cerebellum, which were dealt with effectively with radiation months ago, are continuing to shrink. Yay!
The results of the CT scan are ambiguous, unfortunately. All the sites of the original cancer (stomach, liver, and large lymph nodes near intestines) looked good, but there are some smaller lymph nodes near the stomach that are now larger. They were .4 cm before and are now .9 cm. Dr. Brooks said they could be "reactive," meaning there's an infection or local inflammation, or it could be "early local metastatic adenopathy" (meaning the cancer has spread).
There's no way to tell at this point. Dr. Brooks said the lymph nodes are too small for a PET scan to help, so we just have to wait until the next CT scan is done three months from now to see if they shrink or get larger. He said he's not overly anxious about them and we shouldn't change the current treatment protocol.
I would feel better about this if David's CEA tumor marker has been holding steady, but it's been increasing the last several times it's been measured. When we asked about that, Dr. Brooks' NP said they put more weight on the CT scan than the CEA value. So, for now, we'll hope for the best and try not to worry.