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First, a technician draws a vial of my blood, then he injects me with a sugar solution mixed with a mildly radioactive material. “Nothing dangerous,” he tells me. The PET scan works differently than the CRT or the MRI in that it looks at the mitotic activity (cell division) rather than at a particular organ. Cancer cells grow and divide more rapidly than normal cells and therefore need more energy – glucose (sugar) – than non-cancer cells. Somehow any cancer cells feasting in one of my organs will, with the help of the radioactive sugar solution, produce a sharper image than my regular cells.

After the injection, I have to sit in a lazy boy in a dark, quiet room for 45 minutes. I cannot even listen to music or read. The only activity allowed is relaxation and this is something I am bad at, especially in the middle of a regular work day.

Fidgety and a bit restless, but not anxious, I pull out my Blackberry. I check earlier phone messages and emails, then with no cell phone reception in the room, I am left with nothing else to do. I start to play Break the Brick Wall. I suck at it. Every game is over before I can get to the second screen. Try again! my Blackberry urges me. I read the instructions and start getting better when I realize my heart is pounding, my adrenaline pumping. I am hardly in the relaxed stage prescribed. What if I screw up the whole test? Reluctantly, I stuff the Blackberry back into my purse and close my eyes and try to force myself to relax.

The scan itself takes about half an hour. It is surprisingly easy to lie completely still as the bed slides back and forth through the Do-nut hole creating 3D images of possible cancer in the granuloma in my lung or in the lymph node under my heart. “We will send this to your doctor,” I am told, “but it takes 24 hours before he gets it. “Would you also please give it to Dr. Alpha I tell the tech. “Well, all our doctors have access to these. Does he expect it? Yes. Then he will have it an hour after it is done. That is how long it takes to transfer it via the net.”

So an hour after my scan is done, Dr. Alpha will know if I have metastatic cancer or not. If I do, how will he manage to tell me?



My cell phone rings at 7.42 AM. I am already at work.

“Just left you a message at home,” my internist says. “Ignore that one. Just want to tell you the CAT scan was inconclusive. It is nothing to worry about,” he said.” But one should also not ignore it. You understand what I mean? The radiologist being hyper careful and all.”

My internist is setting up a PET scan. He had talked to my oncologist, Dr. Weary “who is on board.”

As soon as I get off the phone with my internist, his  office calls. They need my new insurance information, the PET scan has to be approved before my appointment on Tuesday at 1 PM. “Eat nothing for four hours prior!” I am told.

At home, I go straight to the phone to listen to the message Dr. R. left before he called my cell, the message he told me to ignore and erase.  Like I could.

“R. here. “ (How much training did he have to be able to deliver bad news in a non-threatening, authoritative fashion?) “Looking at the report of the CAT scan, talked to your oncologist and he is on board with what we’re doing.  My radiologist, being super hyper vigilant and obsessive wants us to follow up with a PET scan, don’t know if you ever had one. He spelled it out in a loud, firm voice: P-E-T scan, we want to make sure there is no metabolic activity. (Nicely put, Dr. R., much better than to say we’re checking to see if you have cancer cells that are growing out of control.) “I talked to Weary,” he continued, ” and we really think the little changes in your lung could be the result of radiation.”

Interesting. The “area of concern” is in my lower left lung. I had radiation in my right breast. Besides, aren’t the lungs in your back?

“Dr. Weary has looked at this and is not highly worried,” R. continued, “but agrees that if the radiologist wants this done then we should go ahead and do it. So we will follow up with a PET scan, P-E-T, very similar to the CAT scan but measures metabolic activity, don’t think you have had a PET scan before. It will show if there is any activity in the scarring area which would make it more likely to be a tumor. I hate to leave a voice mail, but I wanted to follow up since the CAT scan was done a few days ago. Jonathan will call and set a time.”

A PET Scan stands for Positron Emission Tomography and it is pretty much only used to check for “abnormal cell activity.” The reason they said that my CAT scan was “inconclusive” must have meant that by just looking they could not tell if my granuloma was benign or malignant.  They had checked the size: small is good but not absolute proof. They had looked at the edges and obviously could not tell for sure if they were smooth or spiculated (smooth is better.) They checked the density: calcified or not?(calcified is better.) They were clueless.  I still needed a PET scan.

I felt like throwing up as I listened to his message over and over again.


CAT Scan Ordered to Check My Lungs

June 12, 2010

My new internist calls unexpectedly at 10.30 AM to give me feed back from my routine check up from three weeks ago. He is back from vacation and has just sorted through his pile of paperwork. My blood count looks great. My cholesterol is 208, but only because I have 108 of good cholesterol, so […]

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