Sorry for the long delay in posting this blog - owing to my health needing recovery and rest as it has been a long slow journey with each day different symptoms stopping me from feeling well enough to be on the desktop computer for longer than a few minutes.
Weds 10 June 2015 I will be admitted overnight for my 4th round of the wonder drug Keytruda. As I have peritoneal and pleural mesothelioma it has been a long and very important wait to see if it would have any affect on my peritoneal area as it has only ever been used for pleural mesothelioma. BINGO it is having success! Just prior to round 3 (3 week's ago) on Keytruda I had a CT/Abdo/Pelvis scan. My oncologist said that there was significant shrinkage of tumours and fluid in the peritoneal area - fantastic, this could be due to my recent radiation in Jan/Feb 2015 and with the drug Keytruda.
Results of scan 10 May 2015
CT OF THE CHEST; ABDOMEN AND PELVISClinical Notes: Peritoneal and pleural mesothelioma. Resected. Restaging after pembrolisumab.Technique: Contrast enhanced imaging. Comparison to CT of 10/3/2015.Findings:ChestThere are now several small lung parenchymal nodules; in keeping with metastases. The largest isin the left lung apex; measuring 8 mm.Minor nodular subpleural thickening at the right lung apex is unchanged.No pleural fluid or new pleural plaques.A right superior mediastinal lymph node is unchanged; measuring 9 mm in short axis diameter.No enlarging mediastinal; hilar or other intrathoracic nodes. No axillary lymphadenopathy.No pericardial effusion.Abdomen and PelvisThe solid and cystic mass in the left upper quadrant; invading or involving the stomach wall; issignificantly smaller; with stomach lumen now better seen.There is generally less free fluid in the flanks and the pelvis.A more defined rounded fluid collection is now seen in the posterior right flank; abutting thelower liver; but not invading it. This measures 49 x 51 mm.
Bowel loops are generally thick walled; and enhancing; which could be due to oedema or surfacemetastatic disease; but there is no small or large bowel mechanical destruction; and no freeair/perforation.A low attenuation subcapsular lesion in the posterior liver; within segment 7; is larger; nowmeasuring 13 x 11 mm. Smaller similar low attenuation lesions within segment 8 superiorly and within segment 2 are alsolarger; all likely due to metastases.No bile duct dilatation. The portal vein remains patent.The spleen and pancreas are intact. Some scarring in the superior left kidney is unaltered. A small cyst on the left. Nohydronephrosis.No discrete adrenal mass.No convincing enlarging retroperitoneal or discrete intraperitoneal lymph nodes.Anterior compression of L2 is unchanged. No new compression fracture; and no frank bony metastaticdisease.
Conclusion: A mixed response:
The large solid and cystic lesion in left upper quadrant is significantly smaller; with less masseffect on the stomach; and there is generally less ascites.There is a new discrete collection in the right flank; and new small liver lesions in keeping withmetastases.Several new lung nodules are also in keeping with metastatic disease; but there is no recurrentpleural effusion or pleurally based thickening nor lymphadenopathy.Small bowel loops are generally thick walled; which could be due to oedema or surface metastaticinvolvement; but no discrete nodules; nor bowel obstruction; is present.
My appetite has improved - I am finding that I am able to have an appetite and eat in small quantities compared to prior of taking Keytruda drug.
The last couple of weeks I have had stronger days with bursts of energy where I have wanted and enjoyed going out, going away for a few days and generally needing less oxygen daily. Nausea is still there however it is usually only once a day.
I believe that this drug is working and keeping me alive! So roll on Wednesday for my next hit!
To all mesowarriors around the world my love and hugs goes out to you.
This is just a short blog however hopefully I will post more frequently as my health improves.