HER2 Support Group Forums - View Single Post

rentrac · 09-10-2007, 08:25 PM

Sorry about my brain damage, but the quote from your radiology report makes a lot more sense now. The only way to rule in/out something absolutely is by biopsy... a rather invasive procedure that everyone would prefer to avoid. Based on the radiologist's reading, while mets in the bones of the skull are possible, there are other things that, in general, are more likely. Try not to worry about it, or even think about it until you have the PET results. Sometimes these studies are like puzzles: the docs need several pieces (types of studies) before they can really put together some meaningful information.

Good luck on your PET. If you've never had one, you'll find that you should plan on a nap for the first hour while your body metabolizes the glucose they give you that has been "tagged" with a radioactive molecule so that it can accumulate in those parts of the body metabolizing the most intensley during that hour (you get a little IV, they inject the glucose, remove the IV, make you comfortable with blankets, pillows and you can snooze the hour away.) That means you can't even read (don't want to accidently highlight normal brain tissue). The idea is that cancer cells metabolize sugar pretty quickly, so those cells will pick up more of the tagged sugar. The scan itself is like a CT expect they don't move you through very quickly, after they do a quick CT that acts as a map on which the PET information is superimposed. The PET just detects the amount of "glow" from the parts of the body that took up the tagged glucose; the more taken up, the stronger the glow. Put the glow spots over the CT, know how much glow is normally expected for each organ, and then unusual activity can be detected. But remember, inflammatory tissue after radiation or surgery, for example, also metabolizes rapidly, so it can show up and NOT be cancer. Thyroid nodules can also do that as well ( I had fine needle aspiration and then a hemithyroidectomy all started because of PET results.... and there was no cancer there... it would be I had the one type of thyroid cancer that is very hard to diagnose based on biopsy only!) So, you can see why you have to look at this as only one piece of a puzzle. It's kind of like a devilish jigsaw puzzle!

Good luck, and keep us up to date. I'll be thinking of you on Friday.
Warmly and glowingly (last PET 2 weeks ago) -
Rentrac

09-10-2007, 08:25 PM	#5
rentrac Senior Member Join Date: May 2007 Location: Eastern NC Posts: 65	Sorry about my brain damage, but the quote from your radiology report makes a lot more sense now. The only way to rule in/out something absolutely is by biopsy... a rather invasive procedure that everyone would prefer to avoid. Based on the radiologist's reading, while mets in the bones of the skull are possible, there are other things that, in general, are more likely. Try not to worry about it, or even think about it until you have the PET results. Sometimes these studies are like puzzles: the docs need several pieces (types of studies) before they can really put together some meaningful information. Good luck on your PET. If you've never had one, you'll find that you should plan on a nap for the first hour while your body metabolizes the glucose they give you that has been "tagged" with a radioactive molecule so that it can accumulate in those parts of the body metabolizing the most intensley during that hour (you get a little IV, they inject the glucose, remove the IV, make you comfortable with blankets, pillows and you can snooze the hour away.) That means you can't even read (don't want to accidently highlight normal brain tissue). The idea is that cancer cells metabolize sugar pretty quickly, so those cells will pick up more of the tagged sugar. The scan itself is like a CT expect they don't move you through very quickly, after they do a quick CT that acts as a map on which the PET information is superimposed. The PET just detects the amount of "glow" from the parts of the body that took up the tagged glucose; the more taken up, the stronger the glow. Put the glow spots over the CT, know how much glow is normally expected for each organ, and then unusual activity can be detected. But remember, inflammatory tissue after radiation or surgery, for example, also metabolizes rapidly, so it can show up and NOT be cancer. Thyroid nodules can also do that as well ( I had fine needle aspiration and then a hemithyroidectomy all started because of PET results.... and there was no cancer there... it would be I had the one type of thyroid cancer that is very hard to diagnose based on biopsy only!) So, you can see why you have to look at this as only one piece of a puzzle. It's kind of like a devilish jigsaw puzzle! Good luck, and keep us up to date. I'll be thinking of you on Friday. Warmly and glowingly (last PET 2 weeks ago) - Rentrac __________________ Oct. 2003: Dx age 48, Stage IIIA Ductal Ca. dense dose neoadjuvent AC. BrCa 1&2 -, ER+, PR-, Her2+. 2004: R mastectomy, 3+ nodes, dense doseTaxotere ( allergic), total hysterectomy, radiationx36 . Tamoxifen x6 mo., Arimidex x9 mo. Jan. '06: Multi left metastatic nodes left neck. Stage IV. Taxol, Carboplatin (allergic to both), Herceptin, radiationx27. Herceptin cont'd. 1 mediastinal met in old rad field. April: 2 brain mets - Rcerebellar, Ltemporal lobe. Gammaknife. Stop Herceptin, Start Tykerb. May: CyberKnife-mediastinal node, Zometa restart. July: New RLung mets. Xeloda add. Jan. 2008: CT: Lung mets shrinking. Fatty liver w/increased liver function panel. Feb '08: MRI: brain mets back, 2nd GammaKnife. June: Migraine headaches from cerebellar tumor. Team for WBR - Choose Craniotomy on Cerebellum only. Aug: Crainiotomy successful. Sept: PET -right lung apex clean; left internal mammary artery appears malignant. Herceptin in future. Left mastectomy?