We looked at the lump on the scan. You can see where it has squeezed through the rib cage and spread out over the exterior of his chest rather than growing inside. It was also possible to make out the much smaller lump lower down, closer to his liver, which is also trying to make its escape from inside the chest cavity.
The plan is to have five radiotherapy sessions, with the beams zapping the lumps at an angle close to the horizontal. This will minimise the risk of hitting healthy lung and liver tissue inside the chest, below the lumps. Side effects are tiredness, probably a bit of "sunburn", possibly a dry cough and breathlessness as a result of the beam being close to the lung, and may be some nausea if it touches the liver. These side effects will "resolve" (to use the doctor's words) in a few weeks.
There will be an appointment probably some time next week to plan the treatment, have a scan to locate exactly where the beams will hit the body and mark Steve's chest with reference points to get it on target every time. This will be followed by five consecutive days of zapping.
In discussion with the registrar - a lovely doctor called Rebecca - we were told they had not been able track down the records of Steve's previous radiotherapy in 2009, when the tube ports had been zapped following the pleurodesis procedure to drain fluid from the pleural cavity.
Luckily, there are photos on the blog of the site of the 2009 radiotherapy (on a different part of his body) which I was able to show to the doctor and the consultant. Using those blog photos helped establish that the cancer has not seeded along the line of the ports and that they will not be treating the same area again, which is something they were concerned about.
The consultant mentioned Steve's weight loss when she examined him. He now weighs only 55.5 kilos, even though his appetite has improved and he has been eating more. On the way back from the hospital we bought Complan supplement drink, full fat milk and doughnuts. Here's hoping that piling on the calories will help put a bit more flesh on his bones and give him some more energy. He is still dropping off to sleep when sitting quietly....
The good news is that Steve's Disabled Parking Permit arrived in the post while we were out and our lovely neighbour Marie signed for the recorded delivery on our behalf. That's a weight off our minds! The business accounts have been finished and sent off to the accountant to do Wride and Company end of year returns to HMRC. Another job ticked off the "putting our affairs in order" checklist. Next week promises to be another busy one with appointments of one sort or another on most days. At least we will be able to put the disabled parking permit to good use on our trips out!