Indignation, apprehension, annihilation

I just took a fantastic voyage through my body courtesy of the PET scans I brought home this afternoon from my exam. My appointment with the melanoma specialist in Portland is Tuesday, so I asked to have the scans copied to a DVD before I left so I could be sure my doc gets them. It’s a good thing I don't aspire to be a radiologist as I could barely discern where in the body I was exactly, much less which tissue might be malignant. At least to me, the mystery remains sealed until Monday.

I can say based on the briefest of phone conversations with Dr. K this morning that there was no sign of melanoma on my brain MR. That’s a small victory. My beautiful mind, for now, remains intact. When I asked about the obvious presence of cancer in my cheek, from which the metastasis was plucked last week, he hesitated and I could hear the clatter of a keyboard. “Ah, that would take some time for me to determine”—meaning there was nothing about it on the radiology report and he couldn’t navigate his way fast enough to the right scan. Perhaps that kind of work is above his pay scale.

My two scans this week were polar opposites. As anyone who’s ever been in an MR machine can attest, the syncopated clanging of what sounds like a really lame steel drum band is disconcerting. The magnetic field and radio waves that pass through your body cause no physical sensation, but on this occasion the experience really messed with my mind. I felt at dis-ease. I had no interest in chatting up the tech whose job it was to get me in and out of there as fast as possible.

Oddly enough, today’s PET/CT was serene by comparison. The tech remembered me from previous exams, making this exactly the sort of relationship you don’t want to cultivate. He was smart and friendly, however, and we talked about the science and technology behind PET. After he injected the radiotracer into my vein, I asked if my pee would glow in the dark tonight. He said probably not, but that if I urinated on a Geiger counter it would probably go crazy.

The genius of PET is that once the radio-tagged glucose is in the body, it localizes in any malignant tissue present because of the high metabolic activity caused by rapid cellular division. The positrons that are emitted by the tracer while glucose is being gobbled up by cancer cells travel a short distance through the body, collide with electrons, and cause an “annihilation” event. Are you still with me? The resulting photons travel in exactly opposite directions and are then detected by a gamma camera that surrounds the body and their incidence calculated by computer algorithms to create images that can be read.

All this trouble just to find some !#&!?% cancer cells.

So the fact-finding mission continues. I can’t change the cards I’ve been dealt, so will just have to play what I’m holding. I'm hoping there's an ace in there somewhere.