Today I had an ENT appointment - they're still looking for a primary tumour, and had a glance at my throat with a trans-nasal endoscope (tickly and eye-watering, but painless - nothing like that "Euarrrgh!" moment when Arnold Schwarzenegger puts the probe in his nose in Total Recall). They also did a biopsy of a salivary gland (a "sharp scratch", as they always put it, but more unnerving than painful).
The room had computer access, and the ENT doctor showed me the PET scan images, which I hadn't yet seen. It's a very elegant diagnostic method. On what must be the standard colour scheme for the software, most of the body appears in varying shades of dull greyish-pink, but areas actively using the radioactive glucose they inject you with show up as bright yellow-green. In some places - for instance, the brain and (for some reason) the tonsils - this is normal. In others, it might also be harmless, though messing up the scan, if you haven't obeyed the instructions to rest and not to talk; there have been cases where the jaw muscles showed up because the patient was chewing gum before the scan. But elsewhere, that activity signifies inflammation, or cancer cells.
In my case, that yellow-green lit up in eight or nine places where it shouldn't, mostly corresponding to metastatic lymph nodes (where the cancer has spread to). There are four where my windpipe meets my lungs, and the rest in my neck and jaw area. It was weirdly fascinating, and I felt strangely calm, to see it in such clarity for the first time.
Irene was in on the appointment, and was OK too. It helped us both that the doctors were no-nonsense and friendly, and while they were out conferring, we had a nice chat with the nurse about the relative merits of cats and dogs.
The scary part was a hopeful possibility. I've had for decades a small lump under my jaw which appears to be a calcified salivary gland; I've had it repeatedly checked by GPs, and passed as harmless. But it showed up on the PET scan. Could it be the primary? If so, identifying it could significantly improve the prognosis. That was why they took the biopsy. I'm quite tense about the outcome.
(Sorry about this post being pretty 'techie' - but at the moment, everything is a whirl of appointments and instructions to read for the chemotherapy, and organising everything else that needs fitting in before that. It isn't giving much time for reflection).
- James
