Round 3 Finished

Yesterday ended round 3 of chemotherapy and finally a return home.   The chemotherapy ran continuously until Sunday evening.  The choice was to either send him home Sunday night so he could be back in early Monday morning for his spinal tap and the last dose of chemotherapy, or to keep him Sunday night so he could continue to get IV fluids, particularly since he has had the problem with kidney stones, and then he's already at the hospital for the spinal tap.  He stayed in the hospital.  I abandoned the family on Saturday to go to a conference out of the country, so Mom is taking care of things.  My parents are in town to help, so she's not totally abandoned.

PET scan is going to be done next Monday morning.  This is an exciting moment.  Or maybe not.  PET scans are one of the neatest things in medical imaging (I'm biased, it's what I spend about half my time interpreting).  This scan utilizes radioactive modified sugar.  This shows where sugar is being utilized in the body.  It turns out that a lot of cancers use a lot of sugar, allowing us to image where the active cancer is and when it has gone away.  The radioactive part of the sugar is really cool.  The radiation particle released is called a positron (PET stands for positron emission tomography).  Positrons are a form of antimatter (yep, Star Trek doesn't make up all their terms).  Antimatter has opposite charge from what matter has.  For instance, a positron is a positively charged electron (the one you have known about since elementary school that has a negative charge).  When matter (an electron) and anti-matter (positron) meet, they don't get along with each other.  They get in a fight, both lose, both are annihilated.  When things are annihilated, they don't simply cease to exist, there's an explosion of sorts, except this is on a very small scale.  Two photons (individual light particles or packets of energy) are emitted in opposite directions from each other.  We take advantage of that with our scanner and detect pairs of photons in parts of the detector opposite each other.  This allows us to tell where the positron came from, or where the sugar is being used by the cancer.  We can tell when there is a lot of sugar being used, or when it's not using anymore sugar, or somewhere in between.

His PET scan will be important.  If the response to chemotherapy looks good enough, then he only gets one more round of chemotherapy (total of 4).  If it's not been treated enough at this point, then he gets bumped to 6 rounds of chemotherapy.  There is even a role for putting people on maintenance chemotherapy, where they get a dose of chemotherapy on a monthly basis for a couple years (or something less intense than getting a week of chemotherapy at a time like he gets now).

A CT scan is also performed with every PET scan.  We will look to see if there are kidney stones hanging around.  Hopefully we don't see any.  This will help with the plan for when to remove the stent.

He has a sore on his tongue again.  Not sure how it happened, but it's there.  Hoping it gets better quickly, that he's able to eat, and that we can avoid any trips back into the hospital for the next two weeks.  His next cycle of chemotherapy is May 4.  I think he needs a Star Wars marathon for that week.  May the 4th be with you!