Moving in the Right Direction

A quick bite to eat before being admitted.

Well friends, I'm back at the hospital for round 4 of chemo. More noteworthy, at my pre-admission doctor's appointment we got the results of my midpoint PET scan.

We got really good news. The tumor has greatly reduced in size from my diagnostic PET scan. At that time, the tumor measured about 15cm x 8cm. It is now about 5cm x 2cm. Dr. Odejide called it about an 80% reduction and said they consider a tumor to be responding well to treatment if it has reduced in size by 50% or more. If they don't reduce by at least 50%, then we would be discussing other treatment options and my prognosis would not be as good.

Besides the size of the tumor, the other thing they look at during the PET scan is glucose absorption to determine how active, or "alive", the cancer cells are. Cells consume a lot of glucose, particularly cancer cells. So a scale called the Deauville five-point scale is used to compare the uptake of a glucose laced with a radioactive substance in the tumor to a couple other benchmark spots (namely, a blood pool found in the mediastinum and the liver). On this scale, 1 indicates no glucose uptake at all in the cancer cells (essentially the cancer cells are dead) and 5 indicates the glucose uptake has increased (which isn't good). (Sincere apologies to anyone who knows what they're talking about on this subject, as I'm sure I just butchered it.)

In my case, the tumor is very much still "alive" and is absorbing glucose at a slightly to moderately higher rate than the liver, which translates to a 4 on the 5 point scale). This is apparently pretty normal for the midpoint scan. The most important thing is that the glucose absorption is significantly lower than it was in my initial scan, so we're moving in the right direction. It basically just means we have to keep at the treatment (which we would have done anyways).

The doctor said that at the end of treatment, the goal is for the tumor to be a 1 or 2 on the scale. In fact, she said that as in most cases of this type of lymphoma, there will probably always be a remnant of some size left in my chest, but as long as the cells are "dead", that's the most important thing.

So, while we would have loved to hear that there was miraculously no sign of a tumor, or that the tumor already appeared "dead", we are very relieved to hear that the tumor has shrunk significantly and the glucose absorption has at least reduced since the initial PET scan. The doctor even called later to reiterate that the scan gave us really good news and that we should feel encouraged!

Now, our prayer is that the chemo will continue to be effective, that the tumor will continue to shrink until it is (for all intents and purposes) gone. As you pray for that, be encouraged and praise God with us for the good news we got today!

Finally, for more encouragement, check out this heartwarming story about soldiers in the Massachusetts National Guard who marched 4 miles to deliver toys for the kids with cancer at Dana-Farber. They were just arriving when we walked in and it brought tears and smiles to pretty much everyone who saw them!