Friday morning I had an appointment with Dr. Sara to find out the results of my PET/CT scan. I think everyone - Dr. Sara included - expected that the results would show that the cancer in my breast and liver was no longer "lighting up" on my scans.
My parents and I were placed in an exam room and Dr. Sara came in shortly after. He explained that he only had about 15 minutes to talk to us because he had to get to a conference. I knew this already since his admin James had called me the day before to ask me if I could come in an hour earlier than my originally scheduled appointment time for this reason. He apologized for not having more time, and said that he needed our full attention and concentration and that he would be very clear. At this point I knew the news was not as simple as we all expected and my heart started pounding loudly in my chest.
Then he told us that the cancer in my breast and my liver was no longer lighting up on the scans. Of course, this is a good thing and what we expected. However, the scans showed something else we did not expect: two small spots on my vertabrae. When I heard this, my mind briefly flitted back to a time earlier this year when I'd heard - I think from Dr. Sara though I don't entirely remember - that when breast cancer has spread to the bones, it is usually considered incurable. But I did not let my mind rest there, because Dr. Sara was still talking and I needed to hear what he had to say.
He said these are not new spots. It appears that they have been treated by the chemo, which makes the bone denser and therefore they more easily appear on the scans. He said he would not have expected any radiologist to find these small spots back in January. He explained that the tests I had scan 3mm slices of my entire body. I get the impression that finding these tiny spots would have been like finding a needle in a haystack. But, now that the denser bone is causing it to show up, they knew exactly where to look and so they pulled my scans from April and January, and sure enough, they were there.
So what now? It is not a clear cut answer by any means. Dr. Sara presented my case at tumor board the day before, and, unlike the time he presented my case after the cancer in the liver was discovered, this time there was no consensus on what the course of action should be. Many doctors would see evidence of the cancer in the bones, consider me incurable, and then change the course of treatment, possibly recommending that I not even go through surgery since the goal would no longer be to cure me, but only to treat the cancer and keep it at bay as long as possible.