Thursday, 23 June 2011

Olympic Tickets

I applied for assorted Olympic tickets in the first ballot, but got only the Judo tickets.  H has had a look at what's on offer in the second ballot, and suggested I try again for Rowing and Athletics.  She seems more optimistic than previously about her chances of having a use for the tickets.


H (and I) had a meeting with her consultant yesterday, in which it was agreed that she should have an MRI scan of her troublesome neck, to help decide about radiotherapy.  She's been getting occasionally pins and needles in the fingers of her left hand, suggesting that there may be some pressure on the nerve root.  Followed by the latest dose of Caelyx.

There was no great urgency about the MRI scan, but the hospital rang this morning to say they had a free slot, so we went.  The radiographer talked us through the scan results afterwards: the tumour on C7 (not C6 as previously reported: their miscount not mine) has grown since her first MRI scan on 3rd March: this may have happened while she was having radiotherapy lower down her spine, before she started chemotherapy.  The tumour is impinging slightly on her spinal cord, and there's an (unrelated) slight bulge in the disc at the front of the spinal column which gives it less room to cope.  Neither the radiographer or H thinks this is an immediate concern, but after discussion with the consultant it's been decided that H will have a radiotherapy-planning scan tomorrow.  She wants to delay the radiotherapy itself for a few days while she canvasses views about its interaction with Caelyx.

Tuesday, 21 June 2011

PET/CT scan

H had another PET/CT scan yesterday.  She was afraid that it would light up like a Christmas tree along her spine and ribs, so I was very pleased that it did no such thing.  Her scalp tumour and one in her lung were bright, but the rest were dimmer than before - the radiotherapy has evidently been effective, and probably the chemotherapy too on most of the tumours.  She tells me that the lung tumour can be removed surgically if it becomes problematic.

The CT part of the scan (they do both at the same time so they can compare features between the two images) showed a crack in the lateral process of a vertebra which would be a plausible cause of her new rib pain, so the radiotherapy she had last week was probably the wrong treatment.  Never mind, I was happy.  H, who has to live with the pain and incapacity of her spine cracking, less so.

Wednesday, 15 June 2011


H is having radiotherapy today on her sore rib - this will probably be a single 'fraction', i.e. a one-off treatment.  There's less need for precision in this area, so it won't be tomotherapy.  We hope it will greatly reduce the rib pain she's been having.

The primary?

H has been looking at her scans.  She now thinks the primary is the abdominal tumour discovered by her biopsy scan, and that it's been the cause of the neuropathic pain she's had for years.  If this is right, the primary could have been discovered by the right scan five years ago (the MRI scan she had then was of her spine).  If it had been found, it would have been removed surgically, and there would have been a significant chance of cure.  It's distressing for H to think that she might be well now if she'd been more cautious about her own health.

Is this right?  H thinks so, and she's an expert.  On the other hand none of the experts who examined her five years ago, including herself, thought there was anything serious (her GP thought there might be a lipoma but was easily talked out of the idea).  And the sarcoma specialist treating her hasn't pointed to the abdominal tumour as a likely primary.

H has always been mildly contemptuous of the overuse of scans, thinking them a poor substitute for medical thought.  In this case, a precautionary scan might have been life-saving.  But this case is fantastically rare.

If the abdominal tumour is the primary, it may have been caused by an IVU (Intravenous Urogram) H had when she was 7 or 8, to look for an underlying cause for a urinary infection.  If so, that's an argument for doing fewer scans, on young people at least.

Monday, 6 June 2011


It was H's 49th birthday yesterday.  She'd like to have another one next year.

Spinous process

The CT scan revealed a small fracture of the spinous process of H's sixth cervical vertebra.  This accounts for the neck pain.  It will have been caused by disease in the vertebra, as detected by the PET scan in March.

On the one hand, this is a minor (but painful) injury to an inessential structure.  On the other hand, it's not reassuring to find that a pathological broken neck is good news.

No immediate treatment is required for it.  But the fracture will probably not heal of its own accord; the doctors (including H) will consider radiotherapy.  And the painful rib may need it too.