PET/CT Scan results

We drove out to Yucca Valley yesterday to meet with the oncologist. It was a good news/bad news kind of thing. The Reader's Digest version is that the breast cancer has not metastasized. But, oh joy, they found out that I have a marble sized stone in my right kidney and that there's some kind of growth on my thyroid which may or may not be cancerous. For those who might be interested in the details, or who have never seen printed results of a PET/CT scan, here you go:

EXAMINATION: PET/CT imaging skull base to mid thigh.

INDICATION: 64-year-old female with newly diagnosed left breast cancer.

PET/CT REQUESTED FOR: initial treatment strategy and detection of possible metastatic disease.

CORRELATIVE STUDIES: mammogram Feb 1, 2012. Demonstrates a 3 cm mass in the left upper outer quadrant.

TECHNIQUE: following the intravenous injection of 13.8 mCi 18 – fluoro – 2 – deoxyglucose (FDG) and a 70 min. delay to allow for uptake of the tracer, images were obtained from the skull base to the midthigh on the GE Discovery LS Fusion PET/CT scanner, along with 3-D reconstruction. Oral contrast was administered and CT scanning was performed through the same area for the purpose of attenuation correction utilizing a GE Lightspeed Multi-detector scanner. Blood glucose at the time of injection was 88 MG/DL. The SUV – max of the liver is 2.7.

FINDINGS: there is normal physiologic uptake of the FDG radio tracer identified within the tonsils, salivary glands, liver, spleen, myocardium, genitourinary and gastrointestinal tracts.

HEAD/NECK: there is a 1.5 cm focus of mild hypermetabolic activity in the right lobe of the thyroid gland, SUV 6. There is no hypermetabolic lymphadenopathy in the neck.

CHEST: there is a 2.5 cm hypermetabolic mass in the lateral aspect of the left breast extending to the skin, SUV 11.3. Bilateral apical fibrosis is present. There are no pulmonary nodules. There is no hypermetabolic axillary, mediastinal, or hilar lymphadenopathy.

ABDOMEN/PELVIS: Cholelithiasis is present. The right kidney contains a 1.7 cm parapelvic cyst. PET and CT images of the left kidney, liver, spleen, adrenal glands, and pancreas are grossly normal. There is no hypermetabolic lymphadenopathy or ascites in the abdomen and pelvis.

SKELETON: there are no areas of abnormal hypermetabolic activity in the skeleton suggestive of neoplasia.

IMPRESSION:

    1.  The hypermetabolic left breast mass is consistent with neoplasm.
    2.  The hypermetabolic focus in the thyroid gland may be an adenoma or carcinoma.
    3.  Cholelithiasis.

If you've made it this far, I congratulate you on slogging through all the multisyllabic words that they include. I do find it all rather fascinating, though, don't you?

The future looks like this: first, I need to get a needle biopsy on the thyroid. I'm hoping that it's benign. If it's not, then I need to find out what my options are for that. I'll also have to schedule with the surgeon to get a lumpectomy done and have the tumor in the breast removed.

Are we having fun yet?

Next Oncologist Appointment

Not until Tuesday, the 29th. Till then, I worry about family members who suddenly might be worse off than I am.

What is a PET scan?

Positron Emission Tomography. No, I don't know what any of that means either. But here's what it involves, step by step.

I arrived at 10 min. to 1 and only had to wait a few minutes before they called my name. Bob and Angie had gone with me and were allowed to come in with me through the whole process. First we went into a very tiny little room with one of the employees there. She turned on a space heater near my feet and told me that it was very important for me to be warm. I don't really know why.

She also gave me a tall glass of something red to drink. It tasted like a cross between Hi-C fruit punch and Kool-Aid with a definite undertone of something bitter and medicinal. I had to drink the whole thing. She asked a lot of the usual questions about allergies and previous illnesses and surgeries, and filled out a lot of paperwork for me.

When that was done, a very pleasant young man named Willie came in and lead us to the actual room. My first view of the device was that it was impressively large and it looked like an elongated doughnut. There was a cylindrical opening through the center area and on the other side was a bed, very narrow with uplifted sides, I suppose to hold a body in place, and supports for the head and shoulders so that nothing moves.

Again, I was given something to drink. It was vile! But like a good little girl, I drank the whole thing. He explained that it was necessary to expand the bladder so that they could get a good look at it inside of me. I'm not sure why I couldn't have just drank some water for that.

Oh, I nearly forgot. Between the first room, where I filled out the paperwork and the third room where the actual scan was done, I was put into another small room where Willie injected a glucose solution into my vein, and I had to sit quietly for about 30 to 45 min. waiting for it to be absorbed into my body. The glucose molecules adhere to certain cells in the body and most especially to cancer cells. I had been instructed that the day before my scan I was to only eat high-protein meals, meaning only meat, fish, eggs, cheese, and dark green vegetables. No sugars or carbs at all.

Which I did. And didn't. The morning of the scan, I was told not to eat anything for six hours before the scan, which meant that I didn't eat anything at all that day, so when I went in there, his little glucose molecules were the only ones in my body and were easily able to attach themselves to the areas that they needed to.

After strapping me down to the bed. He left the room to work the controls and allowed Bob and Angie to stay in the room with me up near my head which was at the far end of the cylinder. I was able to talk to them and listen to them during the process.

The scan took about 25 min., during which time Bob and Angie kept me occupied with their chatter and at my request Bob recited Jabberwocky for me, which I absolutely love. He does it was such feeling. LOL.

When it was over, I asked if I could see the scan results myself. It was fascinating! I was able to see my body from mid-brain to mid-thigh, in a vertical orientation, and spinning 360°. It was very obvious where the cancer was in the breast. It was a large glowing area. He also told us that the scan had taken photos of hundreds of "slices" of my body and he let it run through that rather quickly so I could see my innards all the way from head to hips. Again, fascinating.

Willie said it would take two or three days for results to be read by the radiologists and sent to my doctors. Because his job was just to take pictures, he wasn't able to give me any kind of diagnosis. That's understandable. To my untrained eye, the only area of concern that I could see was the glowing lump in my breast. But I didn't get to do close-ups of any of the areas and I only had a minute to look at everything before we had to leave

So now I'll wait to hear from my doctor and make an appointment for another follow up. Maybe now we can make some decisions about how we're going to deal with this. And if you've been reading this far, you have the patience of Job, and I really appreciate it. Thank you so much.

http://www.youtube.com/watch?v=ofShsSFNnNk&feature=g-u-u

That's the link to a video that was made about an event that happened at the store last week.

The news was about the cash mob which was really good for business and was even covered by the Daily Press. Bob is doing fine but as for me, well, not so much. I will have a PET scan tomorrow so we can try to find out where the hell it is in my body. Rachel has mostly been working the store because I'm feeling kind of weak, and have been at home a lot.

Business hasn't been that great, even with the move out to the college neighborhood. Combine that with my health problems and I think it's time for me to let it go. I know the business can be profitable if someone takes over who can work full-time, which I never could, and do some advertising, and some networking and schmoozing. Until recently, it always paid for itself, paid its bills, rent and utilities.

So, I've put the word out locally that if anyone happens to hear of someone who is retired and likes to read and is looking for a small business to keep busy at, please let me know.

I'm handling all of this pretty well, actually. I'm more annoyed than anything else by the fact that I have to traipse off to all these different doctors and have all these different tests and – it's just irritating how it takes over your life. And Bob's life because he has to drive me everywhere. I've known since around the beginning of February, so it's been over three months of dealing with getting approvals from the insurance company and making appointments and having tests and waiting for results etc. etc. I'll get through it okay. If it hasn't metastasized too badly yet, I'll be fine. I'm a fighter. I've been doing it all of my adult life. Not much can get me down. So don't you worry, okay?