During my annual visit to the cardiologist yesterday, I revealed that I had been conscious of a reduction in my stamina when walking, accompanied by a slight burning sensation (without pain…hard to explain) in my chest. I told him, as well, about the CT scan results and suggested that was the reason for the symptoms. He did not want to make that assumption, so he scheduled me for a “treadmill cardiolite stress test” early Monday morning in Little Rock. I don’t relish driving to Little Rock early Monday morning, especially because the preparation for the test requires me to avoid caffeine in any form for twenty-four hours before the test. The test will, according to the instruction sheet, take four to six hours. The test actually sounds like a convoluted series of tests involving walking at high-speed on treadmills made to mimic steep hills, while technicians inject radioactive dyes into my veins. Sounds like so much fun I couldn’t turn it down! At least I get to wear “comfortable two piece clothing and good walking shoes.” One aspect of the instructions for the test that concerns me is that “it is very important that you remain very still during the imaging,” referring to a segment of the process during which a “gamma camera will be moved over your heart and take several images of your heart…” I have a very, very hard time remaining absolutely still while on my back on a hard surface. My inability to do so is what made it impossible to complete an MRI last year when the doctors wanted a good look at the bone spurs causing pain in my neck and arms. I will just have to wade through it, I guess.
That’s Monday. Then, on Wednesday, my primary care physician scheduled the PET scan. I don’t have full details, but I know it will involve time on a flat surface during which someone will instruct me not to move. Same concerns as above. I don’t yet know when or where the biopsy of the lung mass will be conducted. I assume they will conduct the biopsy regardless of whether the PET scan shows a bright spot (or spots) that could be cancerous. Here’s an explanation of PET scans that I found interesting and informative:
Cancers grow as dividing tissue require nutrients. Cancers require sugar. In order to perform PET Scans a particular sugar is manufactured. This sugar is radioactive. Fluorine-18 flurodeoxyglucose, known at FDG, is the radioactive tracer used in PET Scans. The patient receives this as an injection, getting a small radiation exposure, less than most CT Scans. Cancer cells take up this FDG sugar and it is trapped inside. The PET Scanning machine then measures the radiation signal.
The more radiation the cancer cell takes up, the “hotter” it is on the scan. A lesion that is hot may be cancer. By matching the PET Scan to other tests (such as a CT Scan as in a combined PET-CT) it is possible to tell where a tumor is located, what it is touching and by how hot it is, how likely it is to be cancer.
…PET Scans can detect the spread of cancer. It is critical at the start of the cancer process to accurately “stage the patient.” By knowing whether a cancer may have metastasized, the oncologist can design the proper treatment.
I’m probably getting ahead of myself with this exploration of PET scans, but it’s better to know what I may be in for than to wander into it blindly.
Sometimes, I think patients can explore too thoroughly the procedures they expect to undergo. For example, I could feel my level of anxiety grow while reading about the processes involved in a needle biopsy of a lung mass. It’s one thing to know what the doctors will do; it’s another to imagine the experience in details before the procedure actually takes place. On the other hand, conducting research into the processes is fascinating. I did not know, for example, of the existence of a specialty called interventional radiology. Assuming my reading material is correct, my biopsy will be performed by an interventional radiologist. After the procedure, which typically takes less than an hour (according to what I’ve read), the tissue sample extracted from the lung mass is sent to a laboratory for testing. The results may be known shortly after the procedure, but it could take several days for the report to be delivered to the doctors. Once that happens, I’ll have a much clearer picture of what, if anything, will follow.
Okay, enough for the clinical language of medicine. My next post will be something very different. I don’t know what that will be, but it will be very different and won’t involve my physical health.