I can see clearly now, the cancer's gone

I met with the medical oncologist today, and he was more upbeat and confident this time than he was the last time I met with him. He said the news was good, and that I appear to have some scar tissue from the radiation, but the cancer is gone. I read the radiologist's report, and it sounded much better than the first PET scan I had in August. My tumor had been 5.3 cm x 5.6 cm and the standardized uptake value, SUV, was 11.8.  

SUV refers to the level of activity in a specific area compared to activity elsewhere. Cancer cells are the fastest growing and show the highest SUVs. The baseline of 1 is normal activity while anything higher that 2.5 can indicate metastatic cancer. It can also indicate inflammation which can be the result of radiation, surgery, or injury. Now, the "mass has significantly decreased in size and intensity of FDG uptake." What is now seen at the site of the cancer appears to be about .9 cm x 1.9 cm and the FDG uptake is similar to the background tissue and is "likely representing treated disease with mild post radiation inflammatory change; however, continued attention on followup is recommended to exclude small volume residual disease." My limited understanding of the FDG uptake is that there is glucose in the radiotracer and cancer likes sugar, so where there is cancer you will see a lighter, brighter shading on the scan. The metabolic activity of cancer cells causes them to appear "hot" on PET scans. My SUV is now a "maximum of 2.0," and my lymph nodes also looked good. 

So, I feel pretty good about this and am hopeful that the next PET scan in 3 months will show the same or better results. Maybe by then, someone will develop a better tasting pre-test liquid, because what I had was awful. I don't even know what it was for, because they injected the radiotracer in my port. I did get a nice surprise when I started drinking the second glass, because it tasted like water. After several sips, I realized it was water. Things are not always what they seem.

I'll take "radiation side effects" for $400, Alex.

My good news from Dr. BigHands was followed by some other news from the MRI and CT scans. Apparently, there is still something at the site of the cancer, although it's smaller than the cancer was, and it hasn't been determined if it is cancer. It may be scar tissue or radiation reaction or granulomas. The radiology doctors who read the scans did not come out and say it was cancer, but they hinted that it could be. At least, I think that's what they said. It was in some foreign language, or it may as well have been. I could barely pronounce some of the words, much less understand them. Here is a sampling. Marcel Proust would have been proud of the first sentence:

"Again noted is positive treatment response with persistent thickening and irregularity of the rectal wall approximately 9 cm from the anal verge along the omental aspect from approximately the 12:00 to 6:00 position, measuring approximately 2 cm x 1.4 cm with persistent areas of restricted diffusion as well as scattered patchy enhancement." 

"Adjacent blooming artifact in this region is noted."

I don't know whether to be proud or nervous.

On Valentine's Day, I will be getting a PET scan to see if it picks up cancer there. I think my medical oncologist said that it would be definitive, if it found cancer, but if it did not, I would need further testing, such as a scope to see what is actually there.

So, I'm not out of the woods yet. I'd like everyone to say a prayer or send good vibes or visualize that there is no cancer remaining and that whatever is there is something I can live with. My guts tell me that it's not cancer, but my guts forgot to tell me when the cancer first showed up, so I'm not sure how reliable they are. 

I'll post again after I get the results of the PET scan which should be on 2/17 after I meet with my medical oncologist. I'm hoping that the PET scan shows nothing, and that the subsequent scope will also show no cancer and that all systems will be a "go" for a colostomy reversal.