The first PET scan and Chemo Treatment

Lots of news today.

Leane got back from her first chemo session a little bit ago and is doing very well. She was still in some pain from the procedure yesterday — a thorocentesis where some 2.3 LITERS of fluid were extracted from the pleural sack around her right lung, which successfully reexpanded (she’d had local anaesthesia, obviously); so they added some morphine to the chemo drip for the chemo, which worked well. She was in chemo for nearly five hours, receiving both drugs to mitigate the side effects and two types of chemo — Paclitaxel (Taxol) and Carboplatin (paraplatin). She also received  bone strengthener (stronger than Boniva) and Morphine, thanks to which she did not feel anything.

She had a small Ensure, most of a grilled cheese sandwich and some apple juice and is now sleeping off the narcotics and all the effort from the last two days. She is breathing much better, needless to say and is feeling very good after the first chemo treatment.

Below are the results from her PET scan yesterday morning. The news from that is that the cancer has spread to her bone, but I read that that’s  usually the first place this weird kind of breast cancer spreads to anyway– so these findings are not all that surprising. The chemo works systemically so it will affect whatever is in the bone along with everything else.

Reason For Exam
CA BREAST

PET CT Whole Body
FINDINGS:
18.83 mCi FDG was injected. Whole-body PET CT fusion imaging was performed. The initial blood glucose level is satisfactory.

As has been seen on a recent CT there is a large hypermetabolic mass at
the right neck base, supraclavicular and axillary regions. This has a
maximum SUV of 6.0.

There is hypermetabolic left inguinal adenopathy with a maximum SUV of
2.4. Otherwise no other hypermetabolic adenopathy is seen.

There are numerous hypermetabolic subcutaneous metastatic nodules. These
are seen at teh left posterior neck, right back, left chest wall, below
the right breast, left back and epigastric regions. These have a maximum
SUV of 6.1.

There are bilateral breast hypermetabolic nodules. One the right this has
a maximum SUV of 5.5.

The right breast is markedly engorged.

There is a large right pleural effusion.

There are multiple hypermetabolic osseous lesions consistent with
metastases. These are seen at the right and left scapula, T4, right distal
femur and left iliac bone. They have a maximum SUV of 6.3.

There is increased metabolic activity at the left gluteal musculature.
This may be physiologic.

There are no suspicious hypermetabolic abdominal solid organ masses or
lung nodules.

IMPRESSION:
Large bulky hypermetabolic right neck base, supraclavicular and axillary adenopathy.

Hypermetabolic subcutaneous metastatic nodules and osseous metastases.

Hypermetabolic breast nodules.

End of report

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