Chemo Again

So, the results from the PET scan are in and the cancer is still growing overall.  There were a few small areas of improvement, but overall there is growth or a few new spots of activity.

The plan is to finish the next 3 days on Talzenna and then give me a one week break from any medication before starting the new chemo regimen.  This will be a 2-weeks on, 1 week off, for 3 cycles.  According to my oncologist, I shouldn’t lose my hair, which will be nice for my kids.

When compared to the original PET scan the current one (#6) isn’t nearly as bad, but when compared to PET scan #5 there is definitely significant growth.  Again, as a reminder, the kidneys and bladder are supposed to light up on PET scans, as they are filtering the radioactive sugar isotope that is injected.  My oncologists hope is that the new chemo will be effective, but its just a guess as to if it will do enough in my case.  She’s concerned, and rightly so, about the growth, but we are not in a panic yet.  We still have the “heavy gun” chemo set in reserve, in case things get really bad.  We are just going to keep monitoring things and keep trying different avenues of treatment to find out what will work the best to kill of the cancer.  What concerns her the most is the increased activity of cancer in my liver.  We may later do a biopsy again, depending on how things look, to see if the tumors mutated again in such a way to have another method of targeting them.  For now, we just choose a weapon and attack and scan.  Rinse, wash, repeat.

           

PET Scan #1                            PET Scan #5                     PET Scan #6
July 2018                                     July 2019                         Sept 2019

I asked her about the reason for why she thought that my white cells were so low, given that I was taking the Transfer Factor.  She said that Talzenna (started taking mid July) normally causes white cells to go very low, and can cause low neutrophils (neutropenia).  She commonly sees that in patients.  The fact that I did not have those problems, even though my white cell count did go below normal, she attributes to the Transfer Factor.

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4 thoughts on “Chemo Again”

  1. Hi,

    I am not so sure that scan #6 is as bad as you think. It is zoomed out compared to scan #5. A zoomed out scan is always going to appear worse. If you could compare both side-by-side at the same level of magnification I think you might be pleasantly surprised. Timing is also an issue between dye infusion and scan capture. OK there seems to be some metastases in the liver but I think they were there before. There is a large area over the left kidney but this may be transitory pooling as the kidney sucks the dye our of the bloodstream between heart contractions. I’d wait for another scan before I’d say things have dis-improved.

    Now that you have a CGM it would be an ideal time to measure Breath Acetone as it and glucose levels should oppose each other. It will tell you more than GKI.

    1. First, it is worse. I don’t need to compare them at the same zoom level to know this. I can also feel the lymph nodes and know that they have grown, this is also not good. And there are changes in the liver, but overall there are more metasteses. This is based on the report, and what the doctor said. I trust her. There is nothing to be “pleasantly surprised” about on this scan. I already know that the kidneys and bladder light up, and that’s not something I’m worried about. As far as the breath acetone (BrAce)goes, its not working for me. I’m still only showing very low on BrAce.

  2. Rebecca, ask your doctor if you can increase/double your TF. It is common to do so in cancer patients, and should have no I’ll side effects.

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