I saw the doctor who's filling in for my oncologist today. The good news is that my liver is clear. Yay!
There are some unspecified lung size changes, which isn't really good or bad - just weird. The weird pain I'm having in my side is probably due to my lungs.
The slightly bad news is that four of my mediastinal lymph nodes are enlarged up to 2cm (most around 1.6cm in both major directions). One is right behind my esophagus, another right behind my sternum, a third behind the place where the bronchial tubes split, and the fourth to the right of that. The enlarged lymph node behind my sternum is probably why I was feeling some pain there recently.
These lymph nodes are probably enlarged due to the cancer, because my tumour markers are up, but they could also be enlarged because of the sarcoidosis. I knew the sarcoidosis, which mimics cancer, would complicate things - sigh. If the lymph nodes are enlarged due to the cancer, it means that my mets have progressed a bit.
Progression isn't the end of the world; it's not like the cancer has progressed to major organs, after all. Really, if my mets are going to progress, having it be to some lymph nodes is just about the best possible scenario. Of course progression would mean that it's time for a treatment change. I've been on the Femara for over three years now - way longer than most people stay on it - so having to do a treatment change at this point is no big deal to me. I'd expect that we'd probably try another hormonal treatment for these because my organs aren't affected, so it's highly unlikely that I'd need to do chemo right now.
Honestly, changing to another hormonal treatment is something I'd like to do anyways because the other ones have fewer side effects than Femara. Not having joint pain and not having a hard time moving in the mornings would be a welcome change.
Since the doctor I saw today was just filling in, she wasn't comfortable changing my treatment. She's set up an appointment for me to see my regular oncologist on April 21 so that she and I can decide what to do. Today's doctor also said said that because of the sarcoidosis, my oncologist might want me to see a lung specialist at the hospital instead of waiting for me to see the respirologist on May 26. As well, my lymph nodes might need to be biopsied before we change treatment. I think a PET scan might show if the lymph nodes are enlarged due to the cancer, but PET scans aren't readily available here.
So now I wait. I wish that the appointment was sooner, but waiting for a week and a half won't be too bad, I hope. :)