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.

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....