David got his fifth IV of the Keytruda immunotherapy drug today and we saw Dr. Brooks, who showed us the images from David's recent abdominal CT scan. We already knew the news was good, because Dr. Brooks called to tell us that last Fri., but seeing the images really reinforced how much the liver lesions and the lymph nodes have improved.
Because the CT scan couldn't reveal much about what's going on inside David's stomach with the original tumor, I asked Dr. Brooks if doing another endoscopy would ever be warranted, since that's the procedure that orignally located the tumor and led to David's gastric cancer diagnosis. He said that certainly would be an option, but it is an invasive procedure. So his recommendation is to assume the tumor is under control unless David starts having new symptoms that indicate something has changed. That makes sense, especially since David's CEA tumor marker has been in the normal range.
I asked Dr. Brooks if the term "remission" would apply now. He said "partial remission" means the signs and symptoms of cancer have lessened and "remission" means the cancer is undetectable. And he said that because David's liver lesions are now barely perceptible and his lymph nodes show no adenopathy, it would be correct to say that David is at least in partial remission. He said oncologists rarely use the term "cured" because cancer can always recur, but he stressed that David's current state is definitely something to celebrate.
We also discussed the extreme insomnia that David has been dealing with lately. We're not sure why it's been happening, but Dr. Brooks suggested David try melatonin to see if it would help. So we will do that.
Also, during David's next Keytruda appointment on 3/19, Dr. Brooks will take a blood sample to do the germline genetic test that we discussed a couple of months ago. That will help David's siblings know if they might have an increased risk for cancer.