Indolent, or insolent?

Garfield is both indolent and insolent.

I've been laying low the past few days, because I had an MRI on Friday, and for some reason, it took a lot out of me.  Honestly, laying (lying?) in the MRI machine is sort of relaxing.  Except for when it really starts shaking and it feels like some of your organs are going to fly out, or at least move to other parts of your body.

After the MRI, Rod and I stopped at Minella's for dinner, and got home around 6ish.  I went upstairs and decided to lay down for a few minutes.  Well a few minutes turned into 3 hours.  Woke up around 11, then I was up til 3am since I had taken a 3 hour nap.  Fell asleep, and then the cat woke me up around 5.  Jerk.  Fed him, and then went back to bed until noon.  Sleeping til noon is not normal for me.  Neither is spending the rest of the day watching Downton Abbey on Amazon Prime.  But some days you just gotta roll with it.

Anyhoo, Sunday was also a lost day, spent shopping and cooking and trying to get Rod some healthier eating options.  (Yay Rod!)  Wait, was there a point to this post?  Oh yeah, indolent.  Lazy.

Today, my phone rang, and I could see that it was from Penn.  They generally only call for appointment reminders.  However, since I do not have any upcoming appointments, and I just had an MRI on Friday, I figured it was Dr. Doom and Gloom and I better answer it.

That's where the fun really began, because he was calling to give me the results of my MIBG scan.  Results that I got like 2 weeks ago.  So I said, "How about results from my MRI on Friday?"  Oh yeah, we have those too. "What do they show?"  Growth.

Ooooof.  Growth is not a word you want to hear.  You want to hear stable disease.  You want to hear no progression.  But there you have it, growth.

Carcinoid tumors are so slow growing that they are actually referred to as "indolent."  They are, quite literally, lazy.  Lazy like me watching Downton Abbey all day.  However, my little tumors have decided to get jiggy with it.  They are insolent, not indolent.

But how do we define "growth" aka progression?  There are like, actual guidelines and stuff.  No guessing here:

Response Evaluation Criteria In Solid Tumors (RECIST) is a set of published rules that define when cancer patients improve ("respond"), stay the same ("stabilize"), or worsen ("progression") during treatments.

Evaluation of target lesions

• Complete Response (CR): Disappearance of all target lesions
• Partial Response (PR): At least a 30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD
• Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started
• Progressive Disease (PD): At least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions

So I did a little math on the tumors in my MRI report, and it looks like most of them have about a 20% growth rate, with a few of them closer to 30%.  I'm gonna go ahead and say that pretty much sucks.  Dr. Doom and Gloom says PRRT needs to be done sooner rather than later, so I guess I better get my act together pretty quick.

Darn you, motivated carcinoid tumors!