Latest PET/CT

Last week I had another PET/CT scan to check on the cancer staging. This scan was taken during my third cycle of chemotherapy, having had two readings of CEA levels which suggest that the cancer cell mass is decreasing. The PET/CT basically confirmed the CEA results as you can see from the images here. On top is the latest (June 2010) image of my largest tumour. Below is the result from February 2010, which I showed in an earlier blog. The reduction in FDG avidity is clear.

To quote from the radiologist's report: "The four previously shown areas of abnormality, two on the anterior abdominal wall, one in the para-aortic node and one in the mesentery all show less avidity on visual inspection when compared to the previous PET/CT of 2/2/10. Only the two on the anterior abdominal wall show any avidity. The uppermost lesion on the anterior abdominal wall also exhibits significant reduction in size as shown on the CT component-the other lesions were difficult to see on the anatomic images. This change would suggest that chemotherapy is having the desired effect on the tumours at all sites-there are no new sites of disease. The liver remains clear of metastatic disease. The chest remains clear of metastatic disease."

In summary then, the chemotherapy seems to be having a positive effect. This is not a cure, but it could represent an extension of my time frames.

This is a journey involving ups and downs, with occasional bad luck and good luck as part of the mix. I'm pleased about the latest data, but I have had enough experience to understand the need for detachment. The next scan, or a later blood test, could easily be disappointing. If I am to manage this process, I have to resist both exhilaration and despair. "The data is the data" as we say in science. How else can I deal with this?

Footnote: It is interesting that comparison is being made with February when my CEA was 45 ng/ml, not with April 20 (the start date of my chemo) when my CEA was 78 ng/ml and my tumours were even bigger. In other words, the reduction in tumour size since I started chemo must be even more significant than evident in the Feb/June comparison above.