Cancer Update

James met with the radiation oncologist on Friday.  She reviewed the scan results with us.  We expected her to be completely upbeat about the PET scan and it took us a little while to figure out why she wasn't.  The radiologist that read the scan determines the highest cancer activity level (SUV) in a tumor and assigns an absolute number to it.  That number for James went from a 17 originally to a 2.4 now.  The radiation oncologist concurred that was good news.  However, when she looks at the scan more tissue in front of the original mass is lit up.  She is concerned that it appears brighter than an SUV of 2.4.  Lots of things can light up on a PET scan besides cancer, including infection or inflammation, because those are places where the cells are quickly dividing.  James had 2 major surgeries in the area, so it is possible it is lighting up for entirely different reasons than cancer.  Unless another biopsy is done, there is no way to know for sure.  The radiologist and oncologist agree that it seems the best thing to move forward with radiation at this point.  It is a little disappointing.  Obviously we would both feel better if there were whistles and balloons over how good his scan looked, but we still feel confident with the treatment plan. 

The doctor indicated again that they would try to avoid his heart and lungs as much as they could, but they would undoubtedly get radiated.

On Friday, James got all "mapped" and tattooed (they put permanent dots on his body to ensure that the radiation is in the right place when he goes).  He will start radiation on Tuesday and will have 20 treatments, with weekends and holidays off.  They gave him some suggestions for skin care because the radiation burns the skin going in and going out.  The nurse suggested he keep lots of lotion on both his front and back.   Apparently because the skin is thicker on his back and the radiation gets trapped for a little longer, his back could be affected more.  The nurse also indicated that fatigue would be a significant factor and encouraged James to exercise for a few minutes each day and try to get good sleep at night . We will meet with the radiation oncologists once a week to check up on symptoms.  We are hoping James has fewer side effects than he had with chemo!