poked and prodded

Well, it's that time of year again: scan and less common tests season.

Midnight confession:   First up, my wife has never had a full colonscopy.  Really.  Last time, in 2010, they got stuck at about 6 inches in with the obstruction and all hell broke loose after that. Big C and our journey into the twilight zone, along with many other crises popping.  With the surgeries, the surgeons could feel the "tube" for features. Nothing.   She's been on chemo ever since and no one is eager to do operations, including colonoscopy, while on chemo. She's had some dentistry and a root canal done with the IV vitamin C, etc as a guarantor of antibiotic and healing performance.  So this year, we bite the bullet - to do the 'scope while on chemo.    And of course, everyone looks for me, "WTF", kinda late huh?   Me: "Well hon, you do take a lot of polyp inhibitors" (proposed stuff, not generally accepted).  

So after minute preparations and agreements, we have a selected GI dr, hand picked by the head surgeon with special instructions, a small caliber 'scope, and "No rough stuff".  Whizzzes right through, her anastomosis is so perfectly fused they have a hard time finding it.  One inverted diverticulum and that's it.  No polyps, no negative surprises, it's clean.     

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An extra blood draw for less common blood tests, at the hospital.  More vein wear, grrrrr.

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This year, we decide to just do the CT scan, high resolution at 1.5mm - 3mm with triple contrast on a 256 slice machine.   Although CEA intermittently jumps and cycles over the last 2-3 years, after partial immunochemo interruptions. Then it's a cat and mouse game of inhibitor changes, her CEA is still relatively low, always < 6 vs a super smooth, tight, long term, baseline of 2.2 after 2nd surgery for over a year.  CEA was 14 before 2nd surgery.  However, her AFP marker has risen 36 fold over 5 years, several times the AFP upper limit, and that raises concerns and eyebrows.  With all that dehydroascobate etc drowning the met cells, we figure the FDG avidity is still pretty attenuated like in 2013. No PETs here.  Save the MRI for another time, fingers crossed, we chose the hi-res CT.  

My wife has a tough time with catheter inserts, lots of IV traffic on her veins. ahem. Medical people just don't listen when she tells them to get a top notch sharpshooter, and it's sometimes a multistick disaster when they don't listen or, are overrated.  Finally several drs and techs later, she threatens to walk out of the scan center, and they finally go get one of oncological sharpshooters, who "were too busy" before (their infusions were already under way, they have plenty of staff).  One minute and done on first try.  My wife's poor, abused veins.      

There are no obvious mets or changes.  She has hypodense areas that don't show changes.  So, after "our" independent radiologist's 2nd opinion, she's stable wth no dx'd visible mets. "Just markers" and chemo forever.