The whole story of my pending biopsy

I have had a down-turn in my cancer situation.  Recently I completed my 6th cycle of Halaven chemo.  So, in spite of completing CT scans a couple of weeks ago, which came back clear, Dr J wanted to get a PET scan.  The insurance company began denying PET scans about 9 months ago when my CA27.29 blood tests had been dropping.  I just wasn't sick enough to justify the cost of PET scans.  But, in the last few weeks my blood counts have been climbing.  This justified authorization of PET scans, so that is what I got last week.

The PET scan day came - I went in at 6am, got the scan and then went on with my day just like any other day.  The PET returned results I wasn't expecting.  I was expecting nothing since that is what the CT had just shown.  But, instead, the PET showed activity in my back where it has been before, but has been inactive for a long time.  There are also a couple of new spots on my spine.  Additionally, there are spots on my ribs on both sides.  Finally, soft tissue has been compromised again with at least one lymph node in my stomach that is active.

(Active refers to the cells in each of these regions having a higher uptake of the tracer (radioactive glucose) than other areas.  This increased uptake points out where the cancer is making itself at home.)

All those years ago when I was originally diagnosed with metastatic breast cancer they did a biopsy on my bone.  The pathology showed the cancer was still hormone positive, but HER2-.  (Original diagnosis was triple positive for those of you familiar with this) Now, with soft tissue involved again, we are going to get another biopsy. That is the silver lining of this storm cloud.  I don't know if one result is better than another - it only matters that the tests are accurate and conclusive so we can make the most intellegent treatment decision.

Given that the cancer is back in my bones also I need to remember to talk to Dr. J about going back on a bone strengthening treatment regimine.

So, tomorrow I will have a biopsy.  There is a lot of hoopla involved in any medical procedure.  Arrive 1.5 hours early, wait around, be poked by a needle (at least a needle biopsy is what I am hoping for) and endure 30-45 minutes of waiting around until they will release you into the hands of a driver.  So, local anesthetic and lots of waiting, but I can't drive myself tomorrow.  This is my first medical procedure where I have not had my parents to drive me - first time, but not a big deal - thanks to my amazing friends.  I am so thankful for good friends around me who make this all so easy.

Hoping for un uneventful procedure and highly accurate biopsy results.

Naps on the PET/CT Scan Table

If you are new to cancer world you might like to know what it is like to have a PET/CT Scan.  I always wanted to read a patients account of each treatment type before I had it, because it let me get psyched up.

This morning (6:30 am) I had my PET/CT.  This radioactive, glow-in-the-dark, chills-up-your-spine test itsn't such a big deal, as long as it all goes as planned.  I have had a few.  I do remember my first test though.  The second biggest problem was my nerves.  I just didn't know what to expect.  The biggest problem was the inscy-wincy spider that was spinning a web on the machine.  He was just little, but I just wanted him to go away and not drop down onto my body and crawl up to  my face.  Yes, that was my true fear.

Today's scan was critter free.  

What is a PET/CT Scan Like?
It all starts with trying to limit any physical activity for a day or two before the test.  You don't want any parts of your body metabolizing if you can help it.  Of course this means nothing to eat or drink after midnight... you know the drill.  Because of the fasting, I like to get the test done early.  Also, it is safe to assume that following the test and a good meal you can go back to work, so save as many sick days/hours as possible and just get this out of the way.

When you arrive at the radiology center you will be swept away to a small room with a hospital grade lazyboy recliner.  Using either old-fashioned veins or your sporty-modern port, you will get pumped up with radioactive contrast.  The reactions to this vary.  Some people have a metalic taste in their mouth, I have to steady my equilibrium. Whatever you feel, don't freak out just tell the tech.  I figure, they are trained to know "weird" vs. "scary" reactions, so just keep them informed.

Now you get 60 minutes to nap.  Just kick back, sleep if you can, and let that contrast circulate through your whole body. Admittedly if you aren't used to the plastic lazyboy this may be tough.  If you can't sleep sometimes they have quiet music they can play.  Again, communicate with the tech.  Let him know if you are nervous and see what they can do for you.

Once your entire body is "glow-in-the-dark" (you don't really glow) you get to trade in that icky plastic chair for the narrowest, flattest, coldest board ever made. 30 minutes!  You will get to lie on your back.  And, don't worry, they aren't afraid you will go crazy, everyone gets strapped in.  Just think, if you fall asleep you don't have to worry about your arms slidding off the board. This is the bone-chillin part of the exam.  They keep the scan room pretty cool.  I suggest wearing yoga pants and a longer sleeve t-shirt. Whatever you do, make sure you aren't wearing anything metal or you will have to change into a hospital issued drafty-dress. Brr.
You will "ride" all the way through the machine once or twice.  I think this is to get everything lined up between you, the machine, and the computer read-out.  Then you will move back through the machine as it scans one section of your body at a time.  It is slow, but harmless. That's it.  You can now go get something to eat and get back to the business of your life because all this hype leads up to some more waiting.

You take the test, but the results have to be processed, read by a professional (i.e. not the tech who just spent 2 hours with you) and then results formalized and sent to your oncologist.

So you'll wait.  Like I am waiting now.

Cancer will teach you to really control your mind or it will make you insane.
This blog helps me.  This isn't  my first time to the rodeo.  Because I have had cancer before with a full round of treatment and several scary tests that came back to show everything was fine, I am waiting until I tell most friends and family about this round of tests.  If it is serious, then I will cope with breaking the news again, planning childcare and treatment plans, and psyching myself up for whatever it is.  But, for now it is just me and you.  (You being anyone in the world that finds my blog, so I guess there are a lot of us)  I am giving myself the treatment.  Breakfast out as a reward for taking my test.  Calm days at work- no stress allowed. And enjoying the fact that for today I am cancer free. 
Whether I am cancer free tomorrow after seeing the doctor or not, I am free today.  And, today is all that matters.

I really hope that you get a good zen place.  Learn to control your mind so you can control your emotions and stress, and find your strength.  Is it you and blog world? You and a best friend? A religious leader? What ever it is, Be Strong. Be Beautiful.