Only time will tell... or a biopsy

So we're all done at MD Anderson, and feeling good about the information and opinions they shared. In short, they agreed with my oncologist's original plan to wait a while and scan again. They said it's not unusual for post-treatment PET scans to still show some abnormal metabolic activity. They also said that as long as the lymph node in question continues to shrink and have reduced sugar uptake (which is what PET scans measure) then there is no evidence to suggest that I still have lymphoma. They said that their approach to my situation would be to wait 8 weeks and scan, and if that wasn't acceptable to us they could do a less invasive biopsy (core needle biopsy) to determine whether there is any evidence of persistent disease. They also emphasized that I should not undergo further chemotherapy or a bone marrow transplant unless there was hard evidence (biopsy) to indicate that there is actually still some cancer left. They are going to re-analyze the tissue that was biopsied by U of M back in January to make sure that I was diagnosed correctly, and they don't expect that anything will show up differently. Still, it will be good to have a double-confirmation that I had the type of cancer that we thought I had in case it's not gone.

Another bit of helpful information that MD Anderson shared was about one of the numbers that shows up on PET scan reports. They use a measure called SUV, which is a scale of 0-40 to indicate the rate of glucose uptake in tissue. Normal muscle tissue will have an average value of 2. Lymphoma typically shows up in the 10-20s. The highest number that's shown up in the lymph node in question was 5, and it's now around 3. So MD Anderson said this was a good thing, especially if that value continues to drop with each PET scan I get.

So instead of spending 5-7 days here getting poked, prodded, scanned, etc. Mark and I went to Galveston Island yesterday and bathed in the Gulf of Mexico. We're going to hang out in Houston today and are flying home later tonight. I'm looking forward to touching base with my oncologist back in Kalamazoo once she's received the info from MD Anderson and hopefully we'll all be on the same page about next steps. I may go to see someone at U of M, but I think I'll wait until August 28th when my pre-existing condition waiting period with Blue Cross/Blue Shield will be over. Right now I'm pretty close to maxing out my current student health insurance (do not EVER buy Student Health Insurance) that has a $100,000 lifetime maximum per condition. I feel more comfortable waiting another 4 weeks since hearing what MD Anderson had to say about my situation.