"There is physiologic accumulation of FDG in the myocardium, liver, bowel and excretion tracer in the kidneys and urinary bladder," I read the PETscan results aloud to my mother as we stood outside my surgeon's office embracing the gorgeous sun for a moment. We looked at each other, both scared to say aloud what we were both thinking. Dear God, had the cancer spread?
My mom suggested I go talk to my surgeon about the test results. My stomach turned, my vision became blurry, my eyes swelled and I shook. I wanted to know what those words meant, however part of me could not bear hearing more bad news. I talked to Dr. Mason's assistant and she said that I could sit in the waiting area and Dr. Mason would be with me shortly. Sitting in the waiting area my heart raced with fear and panic. Do I have to have chemotherapy again? Will I spend the rest of my life fighting cancer? Am I going to die?
Dr. Mason entered the waiting room and said, "Everything looks great!" I jumped into attack mode. "What does that last line mean? What is FDG?" Dr. Mason smiled kindly and said, "Come on back, Dear." Dr. Mason ushered me into one of the examining rooms and I asked my questions again. I know Dr. Mason could see me shaking violently and my eyes swelling with tears. He said, "Everything looks great. I cannot remember what FDG stands for, but the G is glucose, which is sugar."
(Note: FDG stands for Fluorodeoxyglucose. When you have a PETscan they take your sugar level first, and then give you an injection of glucose. Cancer cells metabolize faster than normal cells, so the imagining can tell where the cancer cells are in the body.)
I said, "Does 'physiologic accumulation' mean that the cancer has spread." I couldn't believe I was able to actually craft the words. Dr. Mason looked at me with kind eyes, "I need you to take a deep breath and try and relax." He reached out touching my armpit, "Your cancer is all right here. It hasn't spread anywhere and I assure you that we will get it all. We're going to get it all, Dear" He repeated himself again in order for his words to resonate. I felt my body grow less tense. He told me that his only concern is the two lymph nodes still left in the armpit. However, they have shrunk and will be taken out during my mastectomy. I thanked Dr. Mason for being so wonderful and told him that I would see him on July 1 for surgery. "I expect your best work on surgery day," I joked as I walked through the door.
PETscan Findings
There is an abnormal enlarged left axillary lymph node with abnormal FDG metabolism and maximum SUV of 9.9. This mass is smaller than prior study. Smaller left axillary lymph node demonstrates a maximum SUV of 1.9. Left axillary seroma is smaller. Other axillary lymph nodes do not demonstrate abnormal FDG metabolism.
Previously seen left internal mammary chain lymph node is smaller and also demonstrates no abnormal FDG metabolism.
Left anterior 6th rib also no longer demonstrates abnormal FDG metabolism.
Findings are compatible with marked response to chemotherapy.
There is physiologic accumulation of FDG in the myocardium, liver, bowel and excretion tracer in the kidneys and urinary bladder
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