‘cancer’ Category

PET Scan

Today was my PET (positron emission tomography) and CT scan. The PET scan detects areas of increased metabolism, which usually means cancer, since those cells grow and divide much faster than normal cells. They inject me with a radioactive solution that gets absorbed by the body’s cells, and fast-growing cells like cancer absorb it much more quickly. Then the scanner detects the positron emissions from the radioactive decay, and can highlight the areas where the cancer lives. However, since I just had surgery and my intestines are still healing from that, the surgery site will also show up on the scan since there’s lots of new healing growth going on there.

The doctor at the imaging center seemed intrigued by my case, and we chatted for a while after the scan. He said that in 30 years, he’s only seen a few cases of Hodgkin’s of the small bowel, as it’s extremely rare (less than 1 in a million), so he’s surprised and, it seems, a little skeptical. He was also surprised and confused by the diagnosis that I’ve never had Crohn’s disease. He said it’s possible the prednisone I took occasionally for Crohn’s was keeping the cancer at bay for 19 years, but that that’s also a pretty unlikely scenario. He asked me to bring him my previous CT scans for Crohn’s, and he’s going to pull my pathology reports and go over them himself. It’s nice that he’s taken such an interest and wants to be completely thorough in the analysis. I imagine most of the time they just run the person through the scanner, write up a report and send it to the oncologist.

Now I need to wait for the PET results. If they show activity outside the small bowel, then we’ll know for sure that it’s cancer, and it’s in more than one location. If only the small bowel shows activity, then the PET doctor and oncologist will need to figure out how much is due to the surgery and how much is due to the cancer.

Time to drink lots of water to wash the radioactive goo they injected into me out of my bloodstream…

Surgeon

I had my follow-up with the surgeon Thursday. I’m healing quite well from the small bowel surgery of two weeks ago, and all looks good with that. We spent most of the time chatting about the new diagnosis of Hodgkin Lymphoma, and what that means, as well as the doubt now cast on the original diagnosis of Crohn’s disease from 19 years go. The surgeon isn’t quite sure what to believe… he doesn’t think I could have had Hodgkin’s for all that time, but he agrees that the tissue analysis should have been able to detect Crohn’s if it was present. He suggests maybe I’ve had something else all this time, like IBS, and the Hodgkins is fairly recent. As he pointed out though, he’s really just a spectator in all this, as the oncologist and GI are the doctors I’m going to be spending most of my time with.

I’ve called the Johns Hopkins cancer center to ask for a second opinion / analysis on the diagnosis and treatment plan since this is such a strange case.

Oncologist

Tuesday was my first meeting with the oncologist about my new diagnosis of Hodgkin Lymphoma. Overall the appointment went quite well, and Kathie and I left feeling better about the whole situation, now that we had more information and an initial treatment plan. I’ll be going for a PET scan on Friday which will tell us the extent of the disease, and will start ABVD chemotherapy in two to three weeks. The oncologist said that I’ve probably had the Hodgkin’s for over a year, but that since I seem to be in very good health otherwise and have no obvious lymph node problems, it’s probably not too advanced.