My PET scan shows a lot of activity in my bones, but my liver is still clear. That’s the best part– cancer can grow in the liver and shut it down and then you’re dead, there’s nothing you can do about it. But cancer in the bones doesn’t actually kill you. It causes pain, it can eat bone away and make you prone to fractures, and it can break off into the bloodstream and attach to liver, kidneys, lungs, or brain. So we still don’t like cancer mets on the bone, but they are not IMMEDIATELY life-threatening. I’m not going to die in the next 3 months, so I’ll take that good news for what it is.
The last time I just had a CT scan because insurance didn’t approve a PET, so this PET is really being compared to last October. It’s not surprising to see growth and new hotspots. There are some good things: enlarged lymph nodes in my neck are resolved, so that was probably just from an infection or cold or something last Fall. I’ve got very mild growth in the nodes of the chest and under the arm. Not big deals at all.
In case you don’t know how this stuff is measured– they inject you with radioactive material in a glucose solution. Active cancer sites will soak up that material. The amount soaked up is called an uptake value, or SUV. The higher the SUV number, the more active or aggressive the cancer is. The range is 1-15.
There is no activity at all in my abdomen, lungs, etc. The liver doesn’t show anything but one area that we think is just scar tissue or healing liver cells growing back. It’s the skeleton that is not so great. I’ve got spots on my ribs, sternum, all areas of the spine, hips, arm, and sacrum with SUVs of 6-10, that weren’t even seen on the last scan. Others are sites that in October had SUVs of 2-4 and now those are as high as 8.5. There is definitely a new large lesion on my iliac bone that has never been there before.
Of course, I am happy to say the report notes “Visualized portion of brain appears normal.” I knew it! I get that good brain from my mom.
So the plan now is to stay on Herceptin and Zometa, which I get infused every three weeks at the SCCA. I will also continue on the Tykerb (oral) at home, which is a targeted therapy to attack the Her-2 protein my cancer uses to grow. We are now adding Xeloda, another chemo. It is oral, I’ll take 4 pills in the morning and 3 pills at night, for two weeks at a time with a week’s break in-between. It’s all a pain to manage: Tykerb has to be on an empty stomach, Xeloda must be with food but not dairy for an hour before or after, no grapefruit ever, blah blah blah. Besides the lovely GI issues you don’t want to know about, the biggest side effect is hand and foot syndrome. Basically, the toxins build in the capillaries of your hands and feet and cause the skin to burn and peel off. It’s usually manageable if you keep ahead of it with lotion and gloves and that kind of thing. And then of course there is fatigue, which is already a struggle. I’ll start Xeloda tomorrow, so we’ll see how it goes.
So that’s it, now you know more than you ever wanted to about PET scans and my cancer. Let’s hope the Xeloda is easy to tolerate and beats back those hot spots. We’re going to give it 3 months and then see if it’s working. Maybe I’ll get a summer on it. . . it doesn’t cause hair loss, so it would be nice to have a birthday this year with hair!