I apologize for not writing a post sooner. Up until a week ago Monday, not much has been going on. All of my blood panels have been looking normal, well, for me anyway, with the typical rise and fall of my white and red blood counts and my ANC.
On July 10th after I went in for my regular monthly appointment with my oncologist I was feeling so good and energetic that I went home and worked out for the first time in ages. Now it is a month later and I am still working out and other than some intense fatigue last week, I have been feeling well and like I have completely recovered from the radiation treatments.
On July 31st, I had my PET Scan to see if the radiation treatments effectively treated the lesion on my rib in my back. I had the scan a month later than usual to give my body time to heal from radiation. I saw my medical oncologist on Monday this week for my regular appointment and to get the results of my PET Scan. The results are not the worst news, but not the best news either, but something in between, so I will do my best to explain what the results are and what they mean. {oddly enough, the doctor that read my scan and wrote the report is the wife of my medical oncologist}
As far as the lesion on my rib in my back is concerned, the report said that “there is increased sclerosis of the left eighth posterior rib with decreased FDG {fluorodeoxyglucose} uptake, SUV 2.0, previous SUV 4.2. Findings suggest favorable treatment response, with reported interval radiation therapy.” So, the lesion is still there, but its activity is less than half of what it was in the March PET scan. Increased sclerosis is a sclerotic lesion that is an unusual hardening or thickening of your bone. They can affect any bone and be benign or malignant. In general, they’re slow-growing.
I have never had any mention of my lungs until now. I have a “new ground-glass opacity in the posterior lower left lobe that measures 3.0 x 1.9cm and is adjacent to the left eighth rib metastasis. Given the interval development and radiation therapy, this is favored to reflect radiation pneumonitis/fibrosis.” Pneumonitis/fibrosis refers to the signs and symptoms of soft tissue injury resulting from radiation therapy. All soft tissues within the radiation field can be affected, including skin, connective tissue, muscles, nerves, and blood vessels. At this time, it is believed that this is just scarring from the radiation therapy, but my doctor will keep an eye on it. The activity SUV of this spot is 2.6, which is within the range of where my body runs, so hopefully, it will stay that way.
Now for one of the more serious findings from my PET scan. “Subtle new FDG avid lesions in the T8 spinous process, SUV is 2.1 and left S2 segment, SUV is 2.2; worrisome for new osseous metastases.” S2 is located at the level of the posterior superior iliac spine. S2 covers the back of the thighs. What does osseous metastasis mean? Bone metastasis occurs when cancer cells spread from their original site to a bone. Nearly all types of cancer can spread (metastasize) to the bones. But some types of cancer are particularly likely to spread to bone, including breast and prostate cancer. The good news with this finding is that the SUV in both areas is below where my body runs, so just as with the spot on my lung, they will keep a close eye on both sites and see if the activity increases.
The last finding in the report is “Increased FDG uptake within a left supraclavicular lymph node measuring 8 x 15mm. SUV 2.9, previously 2.2.” FDG uptake reflects the tissue glucose metabolism and is usually high in high-grade tumors and relatively low in low-grade tumors. Supraclavicular lymph nodes are lymph nodes found above the clavicle, which is where I had the first two small masses in my neck in February 2022. My understanding was that after my first month on iBrance, both tumors were dead and gone leaving a little bit of scar tissue behind, which I can’t even feel anymore. So this is another area that will be watched closely in the coming months.
I know that this was a lot of information and it certainly was not what I expected to see when my oncologist handed the report to me. We talked about possible changes in my treatment and that there are other drugs that he could put me on should my next PET scan show any increase in activity in the areas that we are watching. He would change my medication because an increase would indicate that iBrance and Faslodex are no longer working. He reminded me that eventually my body will adjust to the current medications and that we will have to make changes. For now I am continuing forward with iBrance and Faslodex until my next PET scan which will be in November.
I wish I had more positive news from this last scan but as I have said many times in the last 4 years, cancer is tricky and in my case it is aggressive, so my doctors and I have to be just as aggressive with my treatment. My oncologist says that cancer is very humbling, and that is so true. Cancer doesn’t care if you are rich or poor, the picture of health or sickly, young or old. If you ever feel a bump that wasn’t there before, you have pain that will not go away, you are constantly tired even with a lot of rest and good sleep or you just don’t feel right; please go see your doctor and find out what is going on. Your body talks to you, you just have to learn to listen.
