Another scan and more waiting

James had another PET scan yesterday.  We met with the doctor shortly after the scan.  So, the good news first, the tumor has shrunk since the last scan.  The not so good news is that the SUV has gone up from 2.4 to 3.9.  It should have been at zero or near zero at this scan.  There continues to be an area of the tumor that lights up near James' chest wall.  No one can tell whether it is cancer or just post-surgical or post-radiation inflammation that is causing the higher SUV.  Options at this point are to have another biopsy or to wait 4-6 weeks or longer and have another PET scan.  The mass is quite close to James' heart, so it is unlikely that a surgeon would be willing to just stick a needle in to get to the mass.  He would likely have to have ANOTHER thoracotomy.  Waiting is of course torturous and if it really is cancer, it will have time to grow and get bigger.  It is also difficult because the radiation oncologist, Dr. Million, said she has not seen these circumstances before.  Most often the scan isn't complicated by surgical changes.  Most often people have a small needle inserted to get a biopsy versus the major surgery that James had.  She isn't sure how to proceed, but because of James' age, she is leaning towards being more aggressive.  There was a resident present who was trying to reassure us.  She asked the radiation oncologist to correct her if she was wrong, but that the increased SUV could have been from radiation.  The doctor quickly responded that that was not the reason for the increased SUV.  The regular oncologist, Dr. Gilbert, also called after the scan with a pretty different opinion of the situation.  She doesn't seem as concerned.  She feels like she has seen this happen, where an SUV goes up, a hand full of times.  The radiologist, the oncologist and the radiation oncologist are meeting on Thursday to review the scans together.  The radiation oncologist agreed to present the data at a tumor board on Friday with all the hemaoncologists, pathologist, and radiologist to weigh in.  It is possible that we will be able to attend that meeting.  So, the waiting continues.  We are certainly discouraged.  James is having a hard time; this is just such a blow.  He describes it like this, "It feels like someone took the wind out of my sails and threw them in the garbage."  At least we still have moments of laughing during all of this.  We are still very hopeful of a great outcome, it is just going to take a little longer.