My mets are again

My mets are again

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This morning, Johns Hopkins MyChart published the interpretation by their radiologists of my CT scans at Kaiser of March 19. In my neck, the radiologists said that a "left supraclavicular lymph node demonstrates loss of sensible reniform shape, and is suspicious for metastasis." In my chest, "increased length of the enlarged left top paratracheal lymph node, which too can represent metastatic disease. Given the location between just various vessels, this would be difficult for percutaneous biopsy." It looks like my remission is over, and my mets are again.

I tend to be proactive and would decide on not to wait for my doctors, so I sent the following questions to my doctors at Hopkins, Kaiser, and NIH:

1. What would you set forward my next steps to be?
2. Does it make sense to do a biopsy of the left supraclavicular lymph node? If so, should that be a JHUH, Kaiser, or NIH?
three. What is the most productive type of genetic testing that will be done on the tissue to inform a higher therapy?
four. Should I go again on nivolumab immediately (either through the clincial trial or, since or not it's been approved, outside of the trial protocol), or await testing, or settle for as true with a novel therapy such as Dr. Apolo's cabo/nivo/ipi trial?
It looks like I'll have a period of uncertainty ahead.

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