Friday, April 10, 2020

$5k PET/CT Full Body Scan with Auxumin Contrast - Results, Thoughts. Decisions.


Yesterday I went to a facility and had a full body PET/CT scan, this time with the $5000 addition of a radiotracer called Auxumin that specifically hitches itself to PCa cells wherever they are in the body. It exposed me to additional radiation which I probably don’t need as it’s gotta be my 10th or 12th scan (14th?! More than 10 anyway Ha!) This is the first one where they injected me with radioactive tracers/compounds and then gave me the warning that I’d literally be radioactive for the next 24 hours and to stay away from other folks, especially small children and pregnant women during said hours. True story.

Anyway.

The report came back quickly today and Dr. Lo posted it for me. We also arranged for a phone visit late this afternoon as opposed to me waiting for 10 days to go to his office.

 A couple of quick definitions; radiotracer is the stuff that was injected into me the IV right before the scan. It’s an expensive radio isotope that hitches itself specifically to PCa cells. Pulmonary modules are, given my history, PCa Mets that have hit my lungs but aren’t large enough for the radiotracer to latch onto

Study Result

Impression

IMPRESSION:

1. Abnormal radiotracer uptake throughout the prostate gland, consistent with tumor.

2. Radiotracer avid pelvic lymphadenopathy, increased in size from 2/15/2020.

3. Subcentimeter pulmonary nodules measuring up to 4 mm, new from 11/5/2018, without focal radiotracer uptake at this time, however, raising concern for recurrent pulmonary metastases.

4. No additional sites of distant metastatic disease identified at this time.”

So, you may be asking yourself what does all that mean? Let me try to explain.

Number 4: No additional sites of distant metastatic disease identified at this time.  This is the absolute best news in the report! The last thing I need is the cancer landing on my liver or in my bones or in my brain. Truly good news, Truly good news!

Number 1: Abnormal radiotracer uptake throughout the prostate gland, consistent with tumor.

I was surprised to see the gland even mentioned as I’ve been under the impression we had pretty well eradicated it along with the extensions that were coming off of it. Turns out that’s not the case which is why the radiologist mentioned it. Despite my radiation efforts of a year ago, there’s still a lot of tumor growing in what’s left of my prostate. 

Number 2:  Radiotracer avid pelvic lymphadenopathy, increased in size from 2/15/2020.

This really came as no surprise as we knew a couple months ago from the MRI that the lymph nodes in the pelvis were, “bulky“ as stated by the MRI radiologist. Now they light up as hotspots filled with PCa cells hence the word “avid”,  and are growing rapidly. This is not good news.

Number 3: Subcentimeter pulmonary nodules measuring up to 4 mm, new from 11/5/2018, without focal radiotracer uptake at this time, however, raising concern for recurrent pulmonary metastases.

When I was diagnosed six years ago, the reason my cancer was stage four was because it had already metastasized to my lungs. Six rounds of poisonous  chemotherapy and eight months of hormone deprivation took care of the mets in my lungs then. But, they’re coming back.

So what all this means, based on everything I know about my history, based on the conversation with my trusted oncologist this afternoon, is that I’ve reached the point where there’s nothing Western medicine can do anymore that doesn’t further erode my already crappy physical state.  I’ve also reached the point where disease is advancing more rapidly and now on three fronts.

He offered, and I agreed, to go see the researcher at UCSF one more time as well as Dr. Lo’s associate, radiation oncologist Dr. Chao, and get their feedback. The researcher at UCSF can let me know if there are any new studies available that don’t involve things to which I will not subject myself. Dr. Chao can advise me if there’s anything radiation can do or, probably more importantly, how we go about using radiation for palliative reasons as the cancer progresses (i.e. bone mets)

Since the radiation last March a year ago, I’ve lost right at 50 pounds without even trying. The neuropathy in my hands and feet is a never absent and always a painful presence in my life. Fatigue is a constant battle. It makes no difference how much or little I’ve slept. Yes, I’m tired. I’m really, really tired.

I get winded very easily. Focusing on more than one thing is virtually impossible. My hands feel shaky at times and the physician’s comment today was, “You are symptomatic.”

Yes, yes I am.

And so the process moves on down the road.