Cinco de Chemo

Round Five, the penultimate round.  Before starting this morning we met with our oncology doctor and she confirmed that, indeed, this is the penultimate!  I am once again reunited with the backpack and we will be visiting the infusion center each day this week - it takes about half the day today and then every other day's visit is about an hour and a half to two hours.  Other than these trips to the infusion center I won't get out much this week - not good to go sloshing around town with chemo drugs on my back.

PET #3

It was the results of the most recent PET scan that confirmed that two more rounds should be the end of treatment for me.  This PET was taken between the fourth and fifth rounds and showed very little activity.  To the naked eye looking at the scan, there isn't any brightness there at all so Louie has been beaten down even further (love to see him suffer).  For those of you who enjoyed the grapefruit/shallot descriptor I used last time...Louie is now an invisible cranberry. 

The more we learn the more it seems that the scan may never show the tumor is 100% gone and that isn't what we should be looking for because what may still look like a mass (cranberry) on a PET scan may just be scar tissue...we just want that scar tissue not to show cancerous activity.  The first medical lesson you need to complete in order to understand what we're looking at is SUV - no, not sports utility vehicle - SUV in this context is Standardized Uptake Value.  It's a measurement of how much radioactive glucose the cells are absorbing compared to what is normal for your body.  The higher the number, the more abnormal and because cancerous cells are more active than healthy cells (they divide more rapidly) a higher than normal SUV in the general vicinity of Louie indicates cancer activity.  (There will be a quiz later.)  

In this third scan the SUV was 3.1 - in our first scan, pre-treatment the SUV was 27.1 and in the second scan in which we saw such great improvement it was 6.1.  The baseline for "normal" is apparently your liver and the SUV of my liver is 2.7, which means that the SUV we're seeing in Louie today is only slightly higher than my normal.  We'll do another PET after the last round of chemo and see if the SUV is any lower but our doctor said that she'd be pleased if this was our last scan, meaning it's so slightly over normal that she wouldn't be concerned about it, so that makes us feel positive.  

High Five

I'm going into this round with a renewed commitment to what helped me through the early rounds - a positive mindset and a focus on 'one day at a time'.  I basically know what to expect now but I need to avoid using that knowledge to dread what's coming and instead just hunker down and get through each day, enjoying what I can.  Some days include movies, other days include doughnuts, and this morning we started listening to the book Ready Player One, which promises to be entertaining because it's all 80's references all the time.  So there's always a little positive nugget in there somewhere and where there's a positive nugget, I intend to hunt it down and wrastle it to the ground.  I mean that in the most life-affirming way possible.  (And yes, wrastle is a word; I used to live in Georgia).