12/12/18. Cycle 4. The report from the CT scans. I am well pleased . A lot of support made this happened from great people.

We still have a long way to go. Every journey starts with a simple step. As promised the report from the CT

This first report is of the lung. Upper chest ,the second report is broken down to the lower abdomen. It is one CT scan two reports. The first report was compared to a ct that was done on 9/13/18 . A routine CT that I get every couple months. That is how cancer was discovered. It moved so fast. Within 3-4 months it was everywhere. The PET scan was done on 9/26/18 and it was so bad that it is where the you have weeks to live, we recommend you get your affairs in order we will make you as comfortable as possible. My wife ran out the room.
Words no one is prepared to hear. Not without malice anyway.

Years from now family will read this and see how medicine was done. At least we no longer use leaches. Maybe they will think how barbaric we are with the treatment that is provided.

Below are the reports hope you find them informative

Wolfhart

Report:
Indication: Lung cancer follow-up, assessment of treatment response
COMPARISON: 9/13/2018 Contrast:109 ML OPTIRAY 320; VIA POWER PORT; NO COMPLICATIONS DLP: 1408.3
Scans obtained from the apices through the diaphragms after administration of IV contrast. Sagittal and coronal reformats performed and reviewed.
There has been significant interval improvement compared to the prior exam. The mediastinal windows demonstrate marked reduction in size of the marker nodes previously documented. Node at the precarinal level previously measured 2.4 x 3.9 cm in the AP and transverse dimensions. Currently dimensions are 11 x 18 mm (image 31 series 3) in the same planes. Similarly, subcarinal adenopathy
has diminished from a prior 2.8 x 7.5 cm in AP and transverse dimensions to 14 x 36 mm at the same level (image 37 series 3).
No new hilar masses are present. No anterior mediastinal adenopathy has developed. Supraclavicular and axillary area show no abnormal adenopathy. Noted in the azygos esophageal recess previously measured 2.2 x 1.8 cm. This same node now measures 11 x 7 mm (TR X AP, image 53 series 3)

Lung parenchymal windows show similar improvement. Nodular subpleural mass near the azygos esophageal recess has decreased in size. Previously this had an oblique AP dimension of 6.6 cm a
90 degree oblique AP dimension of 2.8 cm. This same area now has aggregate dimensions of 5.3 x 1.6 cm (image 57 series 4). Parenchymal mass in the right lower lobe currently has dimensions of 18 x 19 mm (image 47 series 4) versus prior 3.5 cm in both planes.
No new masses are present in either lung. Osseous structures demonstrate no lytic or expansile lesions. Increased sclerotic lesion is seen at the T6 level. No erosion of the bony contours present.
The abdomen findings will be discussed separately.
Impression:

.1. Significant interval improvement in the size of the lung parenchymal and mediastinal masses. Residual measurements as noted above. 2. Sclerosis in the T6 vertebral body likely
treated metastases. No other definite similar areas seen elsewhere.

Report:
REASON FOR EXAM: response to tx . Metastatic small cell carcinoma.
Time of the current examination: 12/7/2018 1:44 PM COMPARISON: 9/20/2018, PET/CT scan dated 9/26/2018
TECHNIQUE: Helical post contrast enhanced images were obtained through the abdomen and post contrast helical images were
obtained through the pelvis. Reformatted images are obtained and reviewed.109 ML OPTIRAY 320; VIA POWER PORT; NO COMPLICATIONS
Radiation Dosage DLP: 1408.3 mGy*cm
FINDINGS: CT Abdomen:
CT chest is reported separately.
Patient's known numerous liver metastases are less apparent on the current exam. Portal vein is patent.
There is a stable nonobstructing calculus in the lower pole of the right kidney (image 45 series 2). No left renal calculi are seen.. No hydronephrosis is seen on either side. There are