PET Results

My PET scan results are in. The quick and dirty summary: I'm still stable. Still on watch and wait for now.

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The details:

Getting the results was a little bit of a surprise. I have an oncologist appointment scheduled for tomorrow, and I was planning on getting results then. But Dr. R left a message this morning, saying the results were in, and that I was probably anxious to hear them. (I was anxious to hear them, but not overly so. I could have waited a day. I wasn't obsessing or anything. At this point, given how I'm feeling, I'm been assuming that things haven't changed much. What's he going to say -- "You STILL have cancer"? Why worry?) He apologized for not getting the results to me sooner, because he had been out of town for the last few days. Maybe he forgot I was meeting with him tomorrow?

Still, it was nice of him to call. He's got a good feel for what patients probably need, emotionally. It's why I like him.

A reminder of what the PET scan is:
I had a combined CT/PET scan last week. The CT scan takes a picture of my body, from pelvis to neck. Abnormalities show up, but not in great deatils, so you can't tell what they are, necessarily. A malignant tumor and benign tumor will pretty much look the same on a CT scan. The PET scan gives more detail. Malignant tumors consume a lot of sucrose, a kind of sugar. So I take a radioactive sucrose solution before the scan, and it will show up on the scan by glowing in places where the tumors are eating the sugar faster than normal cells would. They layer the PET over the CT, and that's how they know if the CT scan abnormalities are malignant tumors -- they glow.

So here's the deal:

The lymph node in my chest continues to SHRINK. It was 2.3 centimeters in November, during the follow up CT for the summer pneumonia. In January, it was 1.5 cm. This time, it was 1.0 cm. Weird, but not uncommon for Follicular NHL, which can wax and wane. Next time, it might be bigger again. There is overall less PET activity in my chest.

There is a slight increase in activity under my left arm. Nothing huge. In fact, it's small enough to not even say for sure it's cancer-related. Could be a normal swelling of a node due to sweat gland irritation, or something. We'll assume it's related to the NHL; don't want to get cocky. But it's slight.

The area near my left hip bone, where the lymphoma first presented itself, is still the hottest spot, as it has been. No surprises there -- I can feel the cluster of swollen nodes near the surface. There are some nodes on the right side that are also hot (as they had been), but they are less obvious to the touch. There are a few that are higher up on my hip that are swollen, but they're not near the surface, so I don't know where they are or how big they've gotten.

Dr. R says we look at the whole picture when evaluating a PET scan, and he pronounces this one as overall STABLE. Those small fluctuations are normal for Follicular NHL.

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So all of that is good news.

I'm keeping my appointment with him tomorrow, because I want to talk about treatment options. I won't need treatment right away, but I want to know what to expect, and what his feelings are about certain options. If he favors some over others, I want to do more reading about them.

The big thing with fNHL is looking ahead to the sequencing of treatment options. All NHL is upredicatble as it is, and I, naturally, have the most upredictable type of them all. Some people are successful with the first treatment they try, and go into complete (or at least very long-term) remission. Many people will go into remission for a few years, and then need to try something else. But certain treatments can't be used more than once, or can be, but lose their effectiveness a second or third time. So it's important to consider treatments in a particular order, so you're not wiping out options.

I want to ask him about possible clinical trials, too. I'm obviously not at a point where I need to try something desperate and wild and experimental, but there are trials for current drugs that are experimenting with using them in different ways, at different times, in different doses, etc. I'd be open to helping place another piece of the Lymphoma puzzle, assuming it doesn't cut off options or result in nasty side effects. Something to think about.

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I had planned to write today about the kids' first baseball games of the season. That will have to wait a day or two. If I hear anything interesting from Dr. R tomorrow, I'll let you all know.