Karen is currently undergoing her ninth chemo session and all associated side effects. Yesterday we got the results of the PET/CT/MRI scans and I got a copy of the radiologist's report. This scan was compared to Karen's scan from June 1st.
Here are a few snippets from the report:
"Previously a large area of hypermetabolic activity was identified in the liver. This is decreased in size and density. The SUV values is approximately 6. The finding is considered to represent improved metastatic focus. The CT images identified calcification of this abnormality indicating dystrophic calcifications from a treated neoplastic process. The previous examination also identified small focus of activity within the left lobe which is no longer present."
This is translated as "Karen had a lot of big tumors in her liver that have decreased in size and density. The CT scan detected stuff (dystrophic calcifications) you'd expect to see if tissue was dying (neoplastic process). The tumors in her left lobe are no longer there".
"The examination now identified abnormal increased activity throughout the bones of the skeletal system. The SUV values approximately 8. Findings most likely related to a rebound effect from chemotherapy but should be correlated with history physical examination to exclude the remote possibility of diffuse neoplastic disease involving entire bone marrow. "
This either means her entire bone marrow is shot or it's a to-be-expected effect of the chemo. We are assured it's the latter.
"The activity identified within the adnexa of the pelvis previously is no longer present."
In the previous scan they had seen suspicious shadows around K's ovaries. This seems to have cleared up.
"Impression significant improvement identified. Hypermetabolic focus still noted within the liver. The lesion has decreased in size and intensity. It is in the right lobe of the liver."
Essentially Karen's tumors have shrunken but are still there. To paraphrase Dr. Dan "they aren't ice cubes that'll melt away completely".
This is GREAT, GREAT news and when we actually got to see the scans it was obvious the excellent progress Karen has made. This progress is due in large part to the chemotherapy and Dr. Dan but ultimately it has only been possible through Karen's will and determination.
The general consensus of the tumor board and associated oncologists on our team is that it's time to identify and consult with a surgeon specializing in metastatic disease and liver resection. He or she will determine the correct surgical options and we'll go from there.
I think Karen and I are a little hesitant to celebrate just yet but this is terrific news on the whole.
I have a feeling there will be a lot of "hurry up and wait" but that overall things are going to move very fast in the next few months. We remain confident that this is the best approach to treating Karen's disease.