My guts could have their own yearbook

With my 2019 diagnosis of leiomyosarcoma came a bit of knowledge about my liver.  I had several small hemangioma (a benign cluster of blood vessels that isn't uncommon) that were initially alarming, but then confirmed with more imaging to be hemangioma.  Alarm turned off.  Every scan though, my liver cried wolf.  ALARM Your liver!  Oh, it's ok.  ALARM Your liver!  Oh, that shouldn't be a problem.  

Then came the last 3 scans.  

The first MRI (beginning of 2021) showed growth of some of the hemangioma.  It isn't unheard of for them to grow, but it would be unusual.  I'd gotten pretty used to hitting the snooze button on the liver alarm by this point, too, and didn't think much of it. The scan also showed a small mass on my right back/waist.  We decided to do another MRI in 6 months and check on these areas.  

Quick commercial break to explain why there were so many MRIs.  CT and PET scans are also commonly used with cancer patients.  Both involve radiation, where an MRI does not.  My RB1 gene that was found to be abnormal also comes with a sensitivity to radiation, ie, minimize exposure as much as possible.  This is where the conversation about risk vs reward comes in.  Does the risk of exposure to radiation outweigh the information gained by the imaging produced by the CT or PET scan?  At this point, I've had 6 CT scans and 9 MRIs.  It's not about one scan, it's the cumulative effect.  Contrast is another part of this equation.  It's not about receiving contrast once, it's about the cumulative effect.  Unless you're allergic to it, then skip that step entirely, as that's likely miserable.  It's my choice to only do MRIs from here on out, which takes a risk of missing something in my lungs, but I've had plenty of radiation exposure.  It's worth the risk.  *takes ironically deep breath*  

The second MRI (middle of 2021) showed, again, growth of the hemangioma, except that now they were imaging more like liver metastasis/cancer.  IV contrast is used during an MRI and images are taken with specific timing to the beginning of the injection.  To make it very simple, contrast will stay in cancer cells longer than normal cells, so tumors will show up on images much more obviously.  The miscellaneous waist tumor also had grown a tiny bit, but more importantly, it had the great advantage of being fairly superficial for a biopsy.  (Livers aren't all together easy to biopsy, turns out)  That biopsy came back as the same type of cancer: leiomyosarcoma.  Put that whole picture together, and it's a fairly safe bet that the tumors on my liver are also cancer.  

I tell you all of this because, even with the liver aside, that technically makes me stage 4.  

Hindsight and scans to compare, I've likely been stage 4 for quite awhile.  At least since the beginning of 2021, and quite possibly years before.  I could bore and amaze you all at once with all of the life I've lived since being declared stage 4 and given my badge of "months to live."  Surgery, chemo, and radiation aren't on that list.  

My naturopath and I have had next steps planned based on how each MRI has looked.  I wasn't planning to get another MRI after last summer because I knew the treatment options from the oncologist wouldn't be different.  That's still true, but he encouraged me, as there are more options than what we're doing.  At our last appointment, we talked about photodynamic therapy, and the deal was if there was any growth, we'd talk about pursuing PDT.  And that brings us to: Emily and Leannda go to Mexico.