FirST Follow up - Good News

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.