PET Scan

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Positron Emission Tomography (PET) scans can detect areas of cancer by obtaining images of the body’s cells as they work. First, the patient is injected with a substance made up of sugar and a small amount of radioactive material. Cancer cells tend to be more active than normal cells, and they absorb more of the radioactive sugar as a result. A special camera then scans the body to pick up any “highlighted” areas on a computer screen. This helps radiologists identify areas where cells are suspiciously active, which can indicate cancer.
PET scans are not used to screen women for breast cancer as the test has only a limited ability to detect small tumors. PET scans can be useful for evaluation after breast cancer has already been diagnosed, in a number of different ways:
  • to determine whether the cancer has spread to the lymph nodes
  • to determine whether the cancer has spread to other parts of the body, and if so, where (metastatic breast cancer)
  • to assess whether metastatic breast cancer is responding to treatment
PET scans are available in only very few centers, and they are an expensive, sophisticated test that requires special expertise. Fortunately, Cedars-Sinai is one of those centers. Generally, they are used only if a doctor has reason to believe that the cancer may have spread beyond the breast, but in my case, Dr. Giuliano ordered it to establish a baseline against which to compare future test results.

Because the PET scan looks for sugar, I was not allowed to eat sugar or carbohydrates yesterday, or eat at all since midnight last night - not fun, but not a big deal. The other not fun part was starting the IV, since I am a "difficult stick" - they had to poke me five times before they got it right (thank God I'm getting a port for the chemo). After that, they started the fluid, then waited for an hour for it to travel through my body, then did the scan. The wait was actually very pleasant - they put me in a comfy recliner and covered me with warm blankets, and I watched "The Good Wife" on my iPad. The scan was easy too - I had to keep perfectly still for the duration, about 15 minutes, while they moved me in and out of the imaging machine, so I kept my eyes closed and listened to music on my iPhone. iPad and iPhone - two of the greatest inventions ever for sick people.

The only upsetting part was that I was informed before starting the procedure that I wouldn't be able to  come in contact with Ike for 12-24 hours or nurse him for 24 hours. When I made the appointment for the procedure I had specifically asked about this and had been told two hours, so it was frustrating to learn it needed to be so much longer. The radiation in the fluid has a half-life of 110 minutes, so six hours from when it first entered my body, it was theoretically gone from my system. But it's powerful stuff and no one wants to takes chances with a baby, especially me.

This made me realize that the hardest parts of this whole experience are going to be the things that prevent me from being the mother that I want to be to Ike. Ceasing to nurse him is incredibly hard, not being able to hold him is hard (and I assume that's going to happen again when I have surgery), and if the emotional toll makes it hard for me to play with him, laugh with him, cuddle him, etc. - that may be hardest of all. But I also realize that Ike is my greatest motivation to be strong and keep going and get better. And I will, for his sake even more than my own.

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