In January I drew blood for a new molecular residual disease test - Signatera . The test detects circulating tumor DNA.   The first results take about 8 weeks because genetic analysis of your tumor is needed to inform the analysis.  The predictive power for treatment response appears quite impressive.
I was informed today that my test results are negative - which combined with the news from the previous post would indicate that my first line treatment is working very well.
I am scheduled to begin a 6th cycle of treatment (Keytruda/Padcevv) next Friday and will discuss next steps with my medical oncologist.
In addition to hair loss, I've started to have a runny nose and a bit of taste change.  Claritin did a fine job of clearing up the runny nose.

On March 6, 2024 I had a first PET/CT follow-up after 4 cycles of treatment with a combination of Keytruda and Padcev.  It took a bit of courage to press the button on my patient portal to bring up the radiology report which was available the next day.  My first PET/CT on November 11, 2023 showed very active pelvic  lymph nodes and changed my staging up to Stage 3 or 4 disease.
The news couldn't have been much better - the lymph nodes were no longer showing evidence of disease and there was no evidence of further spread.  As noted in the previous post when I had surgery in January no evidence of recurrence of the primary tumor was seen inside the bladder.

I attribute this to God's grace:
By the skills and persistence of those who developed my cancer treatment.
By those who participated in clinical trials to motivate accelerated approval of this treatment by the FDA.
By Medicare which allows me to afford and take advantage of this treatment
By my care team at the University of Tennesse Cancer Institute who arranged for and guide my treatment.
By my fasting regimen which I believe minimized adverse effects of treatment and may have contributed to treatment efficacy.
By the privilege to participate in the development of PET/CT at CTI/Siemens which found and monitors the presence of my cancer.
By prayers offered for me by so many family and friends and my church family.

I will continue treatment to see if my response is durable.  In January I gave a blood sample to run a new test - Signatera.  The first test uses DNA from resected tumor to inform bloold analysis which detects circulating tumor DNA to identify if there is any molecular evidence of residual disease.  This will complement my next follow up PET/CT.