Sunday, 27 September 2015

Leo is being obstructive

Those of you who have read the blog from the early days will know about "Leo".  Inspired by other meso warriors, it's the name Steve gave to his cancer in 2009, not long after he was diagnosed with mesothelioma in the lining of his right lung.  

Leo has been sleeping quietly for much of the time since then (albeit we have been reminded of his presence every three months or so when hospital assessment dates come around). For sure, there have been difficult times when Steve has had treatment - chemotherapy and drug trials - with nasty side effects.  However, the cancer itself had no direct, significant physical impact on Steve's day-to-day life for some five years. It almost seemed like tempting fate to keep referring to Leo during this period, so I haven't mentioned him by name very often in recent years....

However, Leo has reared his ugly head quite spectacularly over the last twelve months or so, and we can't pretend to ignore him any longer.  He's spread himself around a bit, making unwelcome appearances in Steve's liver and spine, invading the left lung, growing in the right lung, tunnelling through the chest wall and squeezing through Steve's ribcage, popping a rib in the process and causing the first real pain directly related to the cancer.  

A course of radiotherapy last December shrank Leo's visible presence a bit, but the lump on Steve's chest started growing again in August.  Consequently, at his hospital appointment on Thursday, Steve was expecting to discuss a further course of radiotherapy aimed at the external lump. However, Dr P (the medical oncologist) was not concerned about the visible chest lump - it's not causing pain, affecting movement or near any vital organs.  

She was worried however about a tumour nodule in his left lung which is severely constricting the air passage to the lower lung lobe.  Although the passage is still open sufficiently for air to get through at present, there is a concern that any further growth could close it off completely causing this part of his lung to collapse.  

People can, and do, live successfully with only one lung.  This is because the remaining lung expands into the space vacated by the collapsed/removed lung and increases its air capacity to compensate for the loss of the affected lung.  Which is great if your other lung is working properly.  Not so great if the capacity of your remaining lung is reduced and constricted by tumour growth, like Steve's right lung.

So...the race is on to keep the left lung airway open and make it bigger.  Dr P is hopeful that a stent can be inserted to expand the affected air passage. However, the blockage is quite deep into the lung which will make it difficult, maybe impossible, to insert a stent.  We are waiting for the specialist to advise.  Nevertheless, a further course of radiotherapy with the LINAC (Linear Accelerator) will be arranged regardless of whether a stent can be used. Five sessions over five days aimed at the nodule that's restricting air entry.  

Leo, you will soon be zapped again!

Now we wait for dates.....

Steve has taken this news remarkable well.  I think it helps him to know the reason for the problems he's been having on exertion, and he is reassured by the fact that there are treatment options to deal with the current crisis.  Of course, we don't know what's happening elsewhere in his lungs or the rest of his body.  They didn't discuss the rest of the scan report at his hospital appointment and he didn't ask for a copy to look at at home with me afterwards, on my return from a work-related trip to Guernsey.  I confess to being a little bit annoyed at the time.  However, in retrospect, perhaps not knowing the big picture in detail is a good thing, as things stand. One crisis at a time is more than enough to deal with at the moment.  No point sweating the small stuff until and unless the big issue is tackled.

So we carry on - taking each day as it comes, enjoying the early autumn sunshine and keeping our fingers crossed for England in the Rugby World Cup!

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