Yin and yang of melanoma

The endorphins released from a 22-mile bike ride out to Oakville and back this afternoon were the perfect antidote to the fluorodeoxyglucose (FDG) the nuclear medicine tech pumped into me prior to my PET/CT scan this morning at OHSU. I feel alive again as the radioactivity in my body gradually dissipates. Ellen should not be at risk of contamination by sleeping next to me tonight.

I’m not big on Chinese philosophy, but the yin-yang of a day like this makes me wonder about the opposing forces that are conspicuously at play within me. The FDG is mostly just sugar water with a radiotracer (fluorine-18) attached to the glucose molecules so the scanner can detect tissues that are metabolizing fastest. Cancer is Olympian in its ability to divide and multiply, which is why FDG-based PET is used so commonly in oncology. It’s the best way to find metastatic disease noninvasively in cancer patients like me.

I don’t presume that my melanoma has spread beyond the skin, but if it has, I’ll soon know. I went to OHSU to have the scan figuring that since my surgical oncologist is on staff there, I’d be able to get same-day results. I’ve been traumatized by the delays I’ve previously experienced after my scans, so driving to Portland for the test seemed like a good work-around. Unfortunately, what I failed to take into account was that my doctor might be in Italy on vacation and thus not at my beck and call. So I’m back in the waiting game as I attempt to persuade his nurse to have another doctor in the group tell me the results. No bike ride is long or hard enough to help me cope with the angst I’m feeling. Perhaps an injection of pure adrenaline is what I need to get through this.

It’s been a while since I had a scan, so the diagnostic outcome is totally up in the air. A negative report (meaning no cancer) is obviously what I’m hoping for, but I’ve mentally prepared myself for some degree of trouble. That might mean nothing more than “wait and watch” areas of suspicious activity, or it could suggest immediate intervention—surgery or strong drugs. Being in the in-between time is brutal as it puts all my plans at risk—not least riding CycleOregon in about a month.

I know strenuous exercise is good for me, but I’m not sure I could handle the postponing of taking more direct action against cancer just to bike around southern Oregon. I guess that’s another one of those questions of shadow and light—yin and yang. There is something dynamic at work here, and it’s now my challenge to be patient and see how it plays out. I should have news soon,