Wednesday, April 9, 2014

To Scan....or not to scan

...that is the question!

I was scheduled for a PET scan last week.  I guess the plan for care for me, with my original advanced stage cancer, was to scan me every six months or so.  My past PET scan was in September.  But, I have had more recent imaging studies (MRI's) just to check out random new symptoms I was having.  Everything came back all clear in those scans, but I always knew that looming ahead was a PET scan scheduled for last week (it has been scheduled for many months).  PET scans detect concentrations of tracer (a sugar-based substance that is injected an hour before the scan.  Regional glucose uptake indicate tissue metabolic activity.  Since cancer is highly metabolic, concentration of the tracer are highly indicative of cancer. I have had three PET scans since my diagnosis (in 9/12, 2/13 and 9/13.) PET scans, CTs and bone scans all use radiation.  Since I am young, I would like to be exposed to as little radiation as possible, which is why I have requested MRI's for most of my imaging studies (I wasn't able to have the MRI's while I had my tissue expanders in, so I had to have CT scans instead).

PET scans are also very expensive.  Which I am assuming is why my insurance decided to no longer cover them as a routine exam.  Since I am not currently having symptoms where a PET scan would normally be the best imaging study to utilize to examine further, I received a nice little denial letter from our insurance company.  So, my oncologist's office decided to do a CT scan of my chest, abdomen and pelvis and bone scan instead.  But, since I recently had an MRI of the abdomen, my insurance company denied coverage for the CT of the abdomen and pelvis.  Hmmm....seeing all of these denials really started making me think:  should I really be having a scan when I am asymptomatic?  I mean, I have been more short of breath than normal, but perhaps that is due to being a little anemic or even a little more out of shape than I used to be.  In the meantime (while I was contemplating and praying about this), I scheduled the new scans.  They were scheduled for this pastFriday, April 3.  It has been over 6 months since my last full body PET scan.   

Also, over the past couple of months, I have asked my BSF (Bible Study Fellowship) group to pray for my thought life as I continue to move into this "survivorship" phase.  Satan loves to try to attack me by putting little thoughts about the cancer coming back, and what my life would look like as a stage 4, terminal cancer survivor.  Of course, I attack with scripture, but I just didn't like how frequently those attacks were happening.  The attacks tend to really rev up around scan time.  With all of these gals praying for me, I noticed something: the thoughts were happening much less frequently.  I am in a peaceful state.  So much so, that I emailed my oncologist's nurse and typed my thoughts on the scans.   I mentioned that I wanted to reduce the amount of radiation I was exposed to, thus asked if I could have an MRI of the chest instead.  Also, I questioned the bone scan, (which involves injecting radioactive material into my body), since any hot or cold spots on that imaging study would need to be further evaluated with a ct or mri anyway.  She emailed back last Tuesday night stating that my oncologist is good with just skipping the scans altogether this time around.  Whoa!   Suddenly, I had mixed emotions.  This is what I wanted, but is it the safest?   The nurse also indicated that NCCN (National Comprehensive Cancer Network) data indicate a majority of cancer patients identify recurrence by the onset of new symptoms (not by scans w/ no symptoms).  I also have to remind myself that God has this all under control.  If he wants me to have a scan, I am sure He will make it very clear to me.  In the meantime, I am to report any new symptoms asap to my oncologist.  

I asked my doctor if I could have a simple blood test instead on Friday.  They thought a cbc and an iron levels check was a great idea.  It turns out, as I suspected, that my iron levels are low due to some excessive bleeding I experienced a few weeks ago.  Some of my other blood levels are low as well--but it could possibly be related.  I go back this Friday so we can try to see if there is a trend.  No wonder I have been so tired and short of breath lately!  It is so nice having an explanation.

I am realizing that my life is likely going to be this way from now on as a cancer survivor.  I have a choice--I can worry about every little new symptom, or pray about it.  Of course, my choice is to pray about what God wants me to do with the symptom--inform my doctor (who will likely want to scan me) and let it rest a few days to see if it resolves.  Worrying doesn't do me any good.  But of course, Satan will always try to hop into my thoughts and encourage negativity/rob me of my joy.  Although, knowing that this is his tactic is very helpful in my battle plan as well.   I have my armor on and am prepared to battle, as this appears to be a lifelong thing.

Ephesians 6:10-18 says, "10 Finally, be strong in the Lord and in his mighty power. 11 Put on the full armor of God, so that you can take your stand against the devil’s schemes. 12 For our struggle is not against flesh and blood, but against the rulers, against the authorities, against the powers of this dark world and against the spiritual forces of evil in the heavenly realms.13 Therefore put on the full armor of God, so that when the day of evil comes, you may be able to stand your ground, and after you have done everything, to stand. 14 Stand firm then, with the belt of truth buckled around your waist, with the breastplate of righteousness in place, 15 and with your feet fitted with the readiness that comes from the gospel of peace. 16 In addition to all this, take up the shield of faith, with which you can extinguish all the flaming arrows of the evil one. 17 Take the helmet of salvation and the sword of the Spirit, which is the word of God.

18 And pray in the Spirit on all occasions with all kinds of prayers and requests. With this in mind, be alert and always keep on praying for all the Lord’s people."

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