PET scan results

After six months of treatment, I finished my chemo therapy about three weeks ago. This Tuesday, I had a PET (positron emission tomography) scan to see whether the cancer was gone. The news is not perfect but it’s not horrible either.

1. The follow-up PET scan shows two areas of continued metabolic activity: (a) the lung nodule biopsied by UNMC last February and determined to be a fungus. My oncologist was not in the least bit concerned with this spot. In fact, he said it would be very unusual for Hodgkin’s lymphoma to migrate to the lung. And (b) a small area deep in my groin, left side, where everyone suspects the cancer originated. This area is more of a concern.

2. The results of PET scans are measured in units called “Standardized Uptake Values.” My SUV was 3. According to Radiopaedia, “The cut off between benign and malignant lesion/nodule is in the SUV range of 2.0-2.5.” However, and for the purpose of perspective, my oncologist said that an SUV of 10 or above almost surely reveals cancer. That is consistent with the literature that I have read (“SUV >10 may predict for an aggressive histology.“).  Consequently, while I could have cancer remaining in the left side of my groin, considering the grand scheme of things, my SUV of 3 is relatively “low.”

Credit: CENTRE JEAN PERRIN, ISM/SCIENCE PHOTO LIBRARY.  This is an example, and is not my scan. The PET scan shows cancerous sites in the coloured areas for a patient with Hodgkin's lymphoma.  The cancer is present in the bilateral and mediastinal axillar lymph nodes.

Credit: CENTRE JEAN PERRIN, ISM/SCIENCE PHOTO LIBRARY. This is an example. It is not my scan. The PET scan in this example shows cancerous sites in the coloured areas for a patient with Hodgkin’s lymphoma. This scan was taken prior to treatment.

3. I will have another PET scan on November 17, 2014 and I will learn the results when I see my doctor on November 20, 2014. If the SUV increased significantly, then I am likely to undergo additional chemo therapy or radiation. If the SUV remains about the same, the doctor may advise “watchful waiting” or a more aggressive approach that would involve additional chemo therapy or radiation, depending, I suppose, on what he had for breakfast that morning.

4. For now, I may work as tolerated. The doctor advises that it takes 2 to 3 months to “recover” from the chemo I have just completed. With that in mind, I intend to reenter the assignment wheels and assume a regular case load starting December 1, 2014, subject, of course, to the November PET scan results. In the interim, I will continue to do work in the office and conduct short hearing such as sentencing proceedings.

The judges and staff at work have been great. In particular, I am especially indebted to Chief Judge Smith Camp, Judge Gerrard, Judge Zwart and the very special people who work with me on a daily basis, Jan, Jim, Kris, Gabi, Ryan and Connie. They have been and continue to be patient and supportive and seldom bark at me even though I whine constantly.

RGK

PS What Miriam Engelberg famously wrote certainly applies to me and I like that about myself:

Image credit: Miriam Engelberg

Image credit: Miriam Engelberg

8 responses

  1. If I interpret the information you present above right, it sounds like your recent results were, on balance, good. The thoughts and prayers of many are with you for a positive outcome to the November testing, Judge.

    With respect,
    Ron

  2. You go, Judge! Your blog has become one of my favorite reads, — your thoughts always get the intellectual juices flowing, and sometimes an extended discussion of your post at lunch. If I was closer to Nebraska I’d tell you this in person over a good single malt some evening. Know that my and my colleague’s thoughts are right there with you…
    mw

  3. Thinking (and will continue to think) good thoughts about your SUV, and working on another story. Ease back in and remember to take a break when necessary.Have a great weekend. I have newfound respect for Huskers football since I found out that Bo likes cats.

  4. This is good news. Cool.

    On the other hand, I have a good set of knives and a dremel with an adequate range of saw blades. And a kitchen island that I’d be happy to clear off. If those dregs need to come out, I’ll be glad to have at it for you. Since I’m not licensed, my rates won’t be too high. I’ll even spare some Bitburger for your anesthetic. My treat.

    Be assured, too: in six years of surgery on rat and cat brains through graduate school, I never lost an animal to the knife.

    Eric Hines

  5. Judge ,
    All in all –sounds like great news and I am happy for you to hear it.
    I am going to assume that your post on the balloons , which I thoroughly enjoyed , means you are feeling more like your old self .
    stay well ,
    Frank

  6. Frank,

    As always, thanks for your concern. I am a little nervous about the need for another PET scan, but I continue to be a “glass half empty” guy. All the best.

    RGK

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