Showing posts with label PET/CT. Show all posts
Showing posts with label PET/CT. Show all posts

March 10, 2014

PET/CT results and new plan

The results of my recent PET/CT scan are the typical, some good and some not-so-good. Nothing has grown a lot, but I do have some new mets. Dr G has decided it's time to add a new drug to the cocktail.

After repeatedly going back and forth over ixibepalone (Ixempra), he checked on the likelihood of peripheral neuropathy this drug causes. 88% of people taking Ixempra develop neuropathy! That is way beyond what I consider an acceptable risk and is inconsistent with trying to balance treating my cancer and living with it. Fortunately Dr G agrees.

In 1999, when I was originally diagnosed with early stage breast cancer, I chose to receive CMF -- Cytoxan, Methotrexate and 5FU -- instead of Adriamycin. My thought at the time was that if my cancer came back, I'd still have a strong drug to go to. And since my paternal grandmother had stage IV breast cancer, I kind of suspected mine might return at some point.

Now Dr G has decided to give me Methotrexate again, since it did a relatively good job in 1999 and was quite tolerable. It comes in IV and oral forms, and he is trying to get my health insurance to approve the oral tablets. If they do, I will take M twice a day on one day, then repeat a week later. It's greatest side effect is that it causes low white blood counts, potentially putting me at risk for infection. I don't know if I will also receive Neulasta to boost my white count.

Now I am waiting for approval and the meds to arrive. In the meantime I started round 14 of Xeloda, went back on Avastin after my second cataract surgery, and continue with Aromasin and Faslodex.

Cancer treatment is very complicated!

February 26, 2014

Lots going on

We have been very busy lately!

Last week we visited Rik's parents and enjoyed some Florida sunshine at the same time. Although the temperature was in the 80s, thankfully my lymphedema arm did not swell from either the long flights or the heat.

On Sunday we re-stocked our fridge at Costco and ended up leasing a new 2013 Nissan Leaf. It was a very busy day…

On Monday I had the second cataract surgery. All went well, and I didn't ask for more Versed, so I remember many details of the surgery. Remembering doesn't seem to bother me. We went out for breakfast at Skillet Diner, which continues to not quite live up to expectations, although breakfast was better than any other meal I've eaten there. The biscuit I ordered with my eggs was enormous and fluffy.

Tuesday was a lay-low day since I was "resting" for a PET/CT scan. No exercise and I was supposed to eat a high fat, low carbohydrate diet starting 24 hours before the scan. The scan was the next day at 11 AM, so I could eat a regular breakfast. I ate some leftover chicken for lunch. After my post-op check with the opthalmologist surgeon, we went to the grocery store and bought lamb chops for dinner, with which I sautéed some greens.

What I always seem to forget about this diet is that not eating carbohydrates (no bread, potatoes, etc.) leaves me feeling hungry. I ate some peanut butter at 11 PM and then fasted until the exam was over today at 2 PM. Believe me, eating breakfast after fasting for 15 hours was delicious no matter where you go!

I get the PET/CT results next week from Dr G. He's told me not to start another round of  Xeloda until after I see him and we speak about next steps in treatment.


October 31, 2011

Today's update

In preparation for today's PET/CT scan, I had to eat a special diet for the previous 24 hours. No carbohydrates at all; high fat and protein. That meant no milk in coffee; hardly any vegetables; no fruit at all.

For breakfast I made a two egg omelet, sauteed in butter, filled with sauteed mushrooms and some cheese and a cup of herbal tea. (Missed my morning mocha ALOT!) At lunch I polished off the rest of the leftover chicken from a couple of days ago. I snacked on a handful of almonds. At dinner, green salad, freshly picked from our garden, and broiled lamb chops. I drank a lot of water too. What did I miss? No bread, potatoes, CHOCOLATE. That last was the hardest to give up, even for a day.

Then I fasted for 12 hours before the scan. I managed to drink all of the glucose solution without too much gastro-intestinal trouble. After the scan, I met some friends for brunch where I devoured a buckwheat pancake topped with strawberries, blueberries, raspberries, and freshly whipped cream and a huge mug of coffee. After I cam home I immediately ate a piece of chocolate, thereby getting my daily dose of vitamin CH. I guess I'll have to have two pieces today to make up for missing yesterday.

I get the scan results from Dr G on Wednesday, as well as my latest tumor markers (hopefully at normal for the first time in a long time). We'll see what comes next.

My Avastin-related bloody nose has subsided a bit and I no longer have mucus running down my face if I can't get to a tissue in time. I am really looking forward to this week off treatment and hope to recover full strength soon.

Now I plan to get some nap time on the sofa, since my evening will no doubt be disturbed by several trick or treaters. We don't really celebrate Halloween. I moved the carved Bob O'Lantern to the front steps and will light a candle in it to encourage some kids to come to the door. Maybe I'll see some neighbors and former neighbors. Teens, stay away. Halloween is for the little kids.


December 30, 2010

PET scan

This morning I woke up extra early to get to the Cancer Institute for my PET scan. Rik walked the dog while I got ready. It was only 23 degrees outside! Thank heavens I bought that long down coat on sale a few years ago.

The prep for a PET scan is:

  • No exercise for 48 hours prior to the test.
  • Eat a no sugar-low carbohydrate diet the day before.
  • Eat a high protein/high fat dinner the night before.
  • Nothing but water after 9 PM.

Because my power port can't be used for the PET contrast, the chemo nurse started an IV line. (The PET solution tends to stick in the port, and would show as a big lighted area on the results that might mask any cancer located in the same spot as my port is placed.)

The PET tech gave me some yummy (not) barium contrast material to drink. It comes in four flavors: mocha, banana, berry and vanilla. I chose the mocha as the potentially least disgusting taste. Then I rested quietly, listening to music. I was told to be completely still, not even turning the pages of a book, so the PET radiotracer solution doesn't show a false positive in active muscles. The barium contrast gave me a bit of diarrhea, which happens in about 25% of people. Yucky but manageable.

After an hour of quiet, I went into the scan room. Lying on the narrow scanner bed with my arms overhead and my eyes covered with an eye mask, I relaxed as best I could. Twenty-five minutes later, I was done.

Rik took me to Cafe Presse, my favorite place to eat on Capitol Hill. It was almost noon at this point and I'd been fasting since 9 PM last night, so I was pretty hungry. I ordered pain et beurre, omelette avec fromage Comte, et chocolat chaud (French-style hot chocolate; basically a bittersweet chocolate bar melted into whole milk and served with a whopping dollop of whipped cream on the side). Rik had steak frites. Everything was delicious, as always here.

We came home and I took Bobka the dog for a nice walk. Now I'm off for a nap. I get the PET results on Tuesday.

December 24, 2010

More cancer?

We saw Dr G yesterday and my tumor markers have been rising slightly for the past three checks. That might indicate that the Faslodex is working (i.e., you get a bump up in tumor markers at first) OR if it's a steady rise, it might mean that the Faslodex is not working. Hard to say. By physical exam, I am "completely stable."

Dr G and I discussed another PET/CT scan, an expensive test which apparently I haven't had since July 2008. This scan measures the cancer's activity by noting how quickly the tumors take up glucose (sugar).

If the PET/CT scan reveals much more active cancer, and it becomes apparent that the Faslodex is not working, the back up plan is for me to start another chemo, Navelbine (vinorelbine), in January.

Dr G tells me that Navelbine tends to be very mild when compared to other chemotherapies, and just as effective as anything else. For those of a medical turn of mind, here is a link to the recent Journal of Clinical Oncology which Dr G shared with me. You may find it interesting. Technical, but interesting. All others, note the abstract's final paragraph:
Conclusion The study failed to demonstrate superiority of any drug in terms of efficacy, but the vinorelbine combination had significantly fewer adverse effects and should be considered as an alternative first-line option.

Wait and see....

July 03, 2008

Scan results - a mixed bag

I got my PET/CT scan results today. The 4 mm lung lesion had a very low uptake value, so for now my oncologist is keeping me on tamoxifen. He's looking into a combined therapy of two anti-estrogens to see if that would be more effective. We will re-scan in 6 weeks. I see the pulmonologist on Monday and he will weigh in on the situation.

(Temporary) reprieve!

July 01, 2008

PET/CT scan

Today I had another PET/CT scan to look at the 4 mm lung lesion and see if it behaves like cancer. I get the results on Thursday and will see my oncologist. If this lesion behaves like cancer, then possibly he will recommend a change in treatment. I don't know whether that will be chemo or another anti-estrogenic drug. The slippery slope may be starting to slide under me....

Because the PET/CT is done fasting, after we finished Rik and I went out to breakfast for me (lunch for him) at Cafe Presse. What a meal we had! Fresh baguette with butter and barely cooked strawberries with coffee to take the edge off my hunger, followed by omelette aux champignons (mushrooms) for me and steak frites for Rik. Truly excellent Belgian-style fries, I could barely resist eating most of his portion. Then I had to wind up with pain aux chocolate, which at this restaurant is more of that fresh baguette with melted chocolate spread over it. Delicieux!

Why the carb fest? I wasn't allowed to eat any carbohydrates, caffeine or alcohol for 24 hours before the PET/CT scan, because they both interfere with dye uptake, and we want an accurate measure of what might be active cancer. So yesterday I ate a high fat/high protein diet: salade nicoise for lunch (lettuce, tuna, hard-boiled eggs, carrots, olives) and hamburger (without bun) and sauteed peppers and onions.

No wonder I missed my carbohydrates!

February 12, 2008

PET/CT results

Today I saw my oncologist for the first time in three months. After catching up with each other, he reviewed the somewhat mixed results of last week's PET/CT scan with me.

There was improvement in the lesions that were of most concern last time, namely in the sternum and on the spine at at T12. This is particularly good news because T12 is so close to the spinal cord. More good news is that there is no other site of metastatic disease.

However, there is increased activity in the iliac bone (in the pelvis) and in the sacrum (lower back). Since these are not weight bearing bones and don't have the potential to cause spinal problems, Dr. G decided not to change my treatment at this point. I will continue on tamoxifen daily and zometa monthly to strengthen my bones.

As he says, "the trade-off in the PET scan is good! The involved bones are neither weight-bearing nor dangerous. The improvement in the spine is welcome(d)."

I'll have another bone scan in April or May, after Passover.

February 06, 2008

Scan update


Yesterday I had my (annual) PET/CT scan. I had to fast from midnight the night before. I checked in and was immediately given valium to insure that I didn't move while the glucose was spreading throughout my body. There's nothing like valium on a completely empty stomach! I was woozy within moments.

Then the tech tried to insert an IV. Twice. She tried to use the veins in my elbow and in my hand. Unfortunately, neither one took. And of course, since I was fasting AND had taken valium, my vasovagal reflex kicked in and I felt very faint. Thankfully a nurse was able to access my port. I developed a huge bruise on my hand which topically applied arnica cream has reduced nicely.

I drank a lovely barium concoction, was injected with the radioactive dye, rested quietly in my valium haze for 40 minutes, and drank another large container of barium. Then they brought me to the scan machine. It's shaped in a ring form. I laid down on the sliding gurney, put my arms overhead and clasped my fingers together, and slid through the doughnut hole. The actual scan seemed to take about half an hour, and the whole process was 3 hours from start to finish.

By this time I was really hungry, so Rik and I went to Glo's for his second and my first breakfast. I felt as though I deserved an indulgent meal, so I had Eggs Florentine (poached eggs atop spinach and an English muffin, covered with hollandaise sauce) served with terrific home fries and some decaf coffee. Rik had Smoked Salmon Benedict and lovingly shared his hollandaise sauce with me.

We were home by 2 PM where I sacked out on the couch in a valium- and carb-induced haze for the next few hours. Although I wasn't actually asleep the entire time, I felt as though I could barely move. I get the scan results from my oncologist next week.

February 04, 2008

PET/CT scan tomorrow

On Tuesday I have my annual PET/CT scan. Since my bony metastases have been mostly stable for more than five years, my oncologist usually orders bone scans. But once a year he orders the (more expensive) PET/CT scan. Thankfully our health insurance covers the costs of both kinds of tests. I usually have a bone scan once every 3-4 months.

The two tests give different information. According to www.webmd.com, a bone scan "is a nuclear scanning test that identifies new areas of bone growth or breakdown". As I understand it, bone scans don't differentiate between healing fractures and metastases. The PET/CT scan gives information about how rapidly cells "take up" glucose. Since cancer cells grow quickly, they will have a faster uptake.

Either way my body gets a lot of radioactive material during the course of a year. But I don't think I glow in the dark....

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I dance with cancer. Oy!