Two weeks after chemotherapy ended was just about six months from my last PET scan. My oncologist ordered another one at the beginning of April.
:: begin Sleen's PSA ::
Whenever a scan is done, I recommend that you request a copy of the images for your own records. It makes no difference if you are able to interpret them yourself. One day someone (maybe even you) may need to refer to those images, and it'll save time and frustration if you've got them handy.
Besides the images themselves, I always stalk the hospital's online patient portal for the posting of the radiology report. At my hospital it usually only takes a couple of days before the document is available for download. I recommend that all cancer patients get a copy of every scan report. It represents the radiologist's impression of the collection of images that make up the scan.
Be warned that reading the results of your scan may be upsetting. To avoid the horrible scenario of reading dire news about your health and then making a frantic plea for an appointment with your doctor, sobbing over the phone-line into the handset of an unsuspecting scheduler, only to find that the next available time slot is two weeks away, it would be smart to make that post-scan consultation before you read the report.
The point is, you must get the report even if it's bad news. To protect yourself from well, yourself, be sure to only read that thing if you're soon to see somebody who can make the best sense of it. Namely, your oncologist.
:: end Public Service Announcement ::
My scan report hit me as a bit pessimistic, especially given the doctor's hopeful statements from a few weeks earlier. I did not call the clinic in distress (this time), even though I had been expecting words like "no evidence of disease" to appear on the document, and they didn't. Instead the radiologist's report identified me as "Stage 4" in no uncertain terms. Excerpts follow:
Dictated at < redacted > Hospital Medical Center
HISTORY: THIS IS A 48-YEAR-OLD FEMALE WHO IS STATUS POST SIGMOID RESECTION FOR STAGE 4 COLON CANCER. THE PATIENT IS CURRENTLY RECEIVING CHEMOTHERAPY AND IS IN FOR FOLLOW UP.
"Currently receiving" was not exactly accurate, since my last chemotherapy treatment happened a month prior. And "Stage 4" was a complete shock to see. Last I knew, I was stage IIIc. Did my staging get changed without my knowledge?
"Well," I thought, "maybe there is some mistake."
1. Currently there are no hypermetabolic foci noted in the neck, chest abdomen or pelvis to suggest hypermetabolic metastases or recurrent neoplasm.
Nothing glowing, not metastatic. Item 1 made the Stage 4 designation all the more puzzling.
2. Only the largest nodule in the posterior right lower lobe is visualized and this shows no FDG uptake... The size of many of these nodules is also below the sensitivity of PET. It could be that more nodes were present, but undetectable due to their small size. Well, that's disturbing.
3. There is no change in left renal calculi and dilatation of the left pelvicaliceal system.
Chemo does nothing for kidney stones. Crud.
Item 2 above referred to my lungs. Tiny spots had been noted there since at least a year prior to my diagnosis. It was conceivable that the spots were nothing to be concerned about, yet the radiologist's last sentence gave me pause. Was it an attempt to redirect responsibility, or was there a possibility that I hadn't been cured after all? It was an unsettling dichotomy.
Typically, if colon cancer were to metastasize, the disease would settle first in the liver, not the lungs. My imagination spun itself into all sorts of scenarios about what might or might not have been happening in my lungs. Ultimately, there was no practical way to know for certain. From the evidence we had at that moment, everything looked great. I decided to rejoice for the good news we were given, and made a conscious effort to not project too far into the future. I had today. I praised God for today.
St. Pio of Pietrelcina's advice to "Pray, Hope, and Don't Worry" was becoming a way of life.