No Evidence of Disease

You know it's good news when the doctor walks into the exam room and says excitedly, "Did you see the scans?"

Further proof of good news is when the doctor uses terms like, "Amazing" and "Awesome." And further proof is when the oncologists tell you they were celebrating in the back room.

Yesterday's PET scans after two rounds of chemo revealed no evidence of disease. If you didn't get the point: this is very good news. Of course, just because you can't see it on scans, doesn't mean there aren't the stray cancer cells lurking undetected. So we will continue with two more rounds of chemo (well, now one round after today's treatment) and then on to stem cell transplant (SCT).   

To be honest, I was approaching the scan results with an optimistic win-win approach. I knew that there would be some remission -- I felt too good for it not to be working -- and so my thinking was if it's Partial Remission is good and means we go CAR T and that's potentially easier than stem cell transplant; if on the other hand it was full remission, well that would be good because it's full remission.

But the truth is, it wasn't "win-win'. It was more like "win-do pretty well." And full remission was always the win. The fact that all my lymphoma responded so well to two rounds of R-Chop bodes well for future rounds and for SCT. Nothing, of course, is guaranteed, and SCT is no picnic, but I'm more hopeful that we can put this in the rear view window soon enough.

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A picture is worth a thousand words, so here's a before (on the right) and after (on the left) picture of PET scans from August (pre-treatment) and yesterday.  

 

The following is from this page on Mayo Clinic's site

"The PET scan uses a radioactive drug (tracer) to show both normal and abnormal metabolic activity.he tracer is most often injected into a vein within your hand or arm. The tracer will then collect into areas of your body that have higher levels of metabolic or biochemical activity, which often pinpoints the location of the disease.  Cancer cells show up as bright spots on PET scans because they have a higher metabolic rate than do normal cells."

Note that in the black-and-white images, the "bright spots" are black. So black = tumors = bad. Note that the brain and kidneys and bladder also show up as black because, I think, they have high activity. But that giant mass in the middle is now gone. There's still some "stuff" - my words - around the neck, reduced but visible, but the interpretation is that this could be/is probably brown fat and not residual disease. Again, do you see the giant accumulation of lymph nodes/tumors in the middle? That's gone.