Radiation, Results & Scan Reductions

Three weeks ago I had my third PET CT and my first MRI scan since adopting a ‘surveillance’ approach to my cancer treatment. I have now been immunotherapy free since December last year, almost twelve months ago.

After a hugely stressful day at Leicester Royal Infirmary yesterday, I am relieved to report that I don’t have another appointment for a scan until April next year, six whole months away. I’m not sure I’ve had a six month break between scans for the past nine years, and calculated that I must’ve have around 50 scans in total since my stage 4 diagnosis.

My day started off stress free, arriving at the hospital four hours before my appointment in order to have my portacath flushed at the Chemotherapy suite. I then began the long wait for my scan results during the afternoon clinic. Around 30 minutes after my my appointment time I was called in to see my Oncologist who explained that the MRI on my head was clear, however my PET CT scan showed a ‘hot spot’ at the top of my spinal column.

Having been diagnosed with a brain tumour nine years ago one of my huge fears is being diagnosed for a second time. The surgery and recovery were brutal and I get emotional just thinking about it. I’ve worked hard to try and block out parts of my life around that time, but it all cane flooding back to me.

Within an instant I felt very distressed, as there were two areas where the scan contrast showed a small area of uptake at my previous follow up appointment. I’d seen the ‘hotspot’ on the scan on the computer screen as I walked into the consultation, and this felt like a nightmare coming true. My mind was racing, worrying that I had another brain tumour, something I’ve been living in fear of for years, and that I didn’t know how I would ever be able to cope with another set back of such a huge magnitude. I have made plans for next year, and have a life to live outside of the cancer bubble. Cancer affects my mental health every day and I felt like the walls I had worked so hard to build up started to crash down around me.

My Oncologist explained that he needed a second opinion, as the MRI result was the more robust and reliable of the two, but something wasn’t quite right. It didn’t stop my mind going into overdrive during the next hour when my parents and I went back to the hospital cafe to try and kill time. Fortunately I didn’t have to wait long for a follow up call, and went back to see my Oncologist a little later. Having discussed with various colleagues in radiography, the conclusion was that I must’ve moved my head slightly during the PET CT scan which then gave a false reading. Who’d have thought moving my head so slightly could cause such a drama!

My scan was a PET CT, PET scan are often combined with CT scans to produce even more detailed images, however it’s likely that I moved slightly meaning that when the two types of images are put together it gave a false reading that I had a ‘hotspot’ at the top of my spine. I’ve had dozens of PET CT scans and never experienced this before, however 45 minutes is a long time to stay still whilst the scanner works it’s magic.

Once the panic had passed and the cause of the contrast uptake determined, we began a conversation around future plans for my follow ups. I find it mentally challenging to keep attending regular scans as each once presents a lot of worry and anxiety in the lead up. With results taking up to a month, I spend about six weeks in every three month period worry about having the scans and then worry about the results once it’s taken place. I’m just going around in circles and the results will never been in my control, no matter how much I wish I could change that. It’s no exaggeration to say after nine years I’m at the end of the road with it and can’t take much more.

I’ve had multiple scans over the years, I’ve lost count of exactly how many. During me appointment my Doctor and I also discussed the frequency of scans and exposure to radiation; as I am now expected to live longer than when I was diagnosed in 2010, and have surpassed expectations, so much exposure could negatively impact my health in the future. We now need to be mindful of how much radiation I’ve been exposing myself to as it may increase my risk of other illnesses, including different types of cancer in the future, oh the irony!

It was decided that as I am not currently showing disease I’ll wait six month for my next scan and follow up results, which hopefully will allow me some breathing space. I want to try and figure out what’s important to my outside of the cancer world, raising money and awareness for charities will always be important to be, but I feel I’ve lost my way and I’m not really sure who I am anymore. I’d like to attempt reignite some of my interests and live the life a 32 year old in London should be living, and not living in constant fear.

It’s so hard living In a world where I’ve been potentially offered a ‘cure’ or long term disease stability when all I can do is worry about my cancer returning. I struggle to shake off the cancer label, but also realise that it sometimes feels like my USP, which is very strange. I got asked recently in causal conversation what was important to me, but didn’t feel like I wanted to expose my diagnosis by telling people that raising awareness and funds for charities was close to my heart. It’s great, but also a bit of an awkward conversation, as I’d feel I would need to give context. I didn’t go on the This Morning sofa with Holly and Phil and speak about my life in YOU magazine for the sheer fun of it.

I am going through a phase of feeling very lost, like I don’t belong or have a place in the world where I feel I fit in. I have some many ‘lost’ days where I feel like I can’t relate to anyone or anything around me. With cancer everything feels like such a battle, from medical appointments to just getting up and getting out of the house every day. I really hope that reducing the frequency of my scans, and only having two over the next year will have a positive impact.

The Wait for Autumn Scan Results

I have been pretty quiet on my blog lately, life has become very hectic, the month has flown by, and I simply haven’t had time to check in on here. I Just returned from a wonderful day trip to Manchester, and my precious weekends have also been spent travelling to see friends around the country. Whilst I’ve loved every moment, I think the fatigue has really caught up with me now and I am glad to have made a few less plans over weekends in November and December.

I had a PET CT and MRI scan last week and I am anxiously awaiting the results in early November. Last time I found it difficult to be pleased with my results given I was made aware of two small ‘hot spots’ which appeared on my scan. My Oncologist, who has treated me for over nine years suggested there was no cause for any immediate concern, however I was really thrown by these small spots appearing on my scan! At the time I had been physically well and expected the results to continue to show no evidence of disease (NED), so when I found out I was caught off guard.

A mixture of a cold and burn out has descended and I don’t feel so well in myself as I did prior to my summer scan results, however this may also be because I’ve not been going to the gym much since I returned from Japan in September, and I know I’ve not been going to sleep as early as I should. I probably need to go back to basics, go to bed earlier and do my best to look after myself.

I’m all for the positive mantra and keep telling myself not to worry about the scan results, as ultimately it won’t chance anything, but there is something niggling at me that I can’t shift. I have been distracted since scan day and find myself drifting off into a negative thought cycle about what may be to come.

The waiting game is really stressful, and it doesn’t get any easier with time. I’ve lost count of the amount of times I’ve been in the oncology waiting room getting ready to speak to a Doctor about my results. I’ve normalised the situation in my head, but it’s really not normal to go thorough this cycle multiple times a year.

Last week I had both my scans within two days of each other which was very anxiety inducing. Once I’ve been cannualated having the scans is easy, it’s the waiting around on the day or for results weeks later that is the worst. I have an MRI scan on my head roughly every six months, as having had a brain tumour one can’t afford to take risks. Praying my noggin is still behaving itself almost 10 years on.

I am fed up of living scan to scan feeling unable to get on with my life, but this is my life now. I hope over time this will continue to get a little easier. By Christmas 2019 I will have been off treatment for a whole 12 months and that is a huge achievement. I will never get rid of the fear around scans, I would love to be able to get the results instantly rather than go through the painful waiting process.

The Day My World Turned Upside Down

Today marks nine years to the day I was told the small subcutaneous lump I’d had removed form my right forearm a few weeks before was cancerous. It was the day my world turned upside down.

A few months before I found a the offending lump and was Immediately concerned, as it became painful and had grown over fairly quickly. When i visited my Oncologist in Oxford we decided that even though didn’t appear to be any real cause for concern, I would be able to have it removed if I wanted. I thought this was best as it was uncomfortable and unsightly.

Six months went by from visiting the team in Oxford to having the lump removed at Northampton General Hospital in September 2010. By this point I had graduated from University and moved to Windsor to start my first job as a graduate.  After I had the lump removed, I was told by the surgeon’s team that I would have to come back a week later. From my previous experience of having the cancerous mole removed from my neck five years before alarm bells began to ring. I gave myself a little pep talk and convinced myself it would simply be because i needed to have the stitches taken out. Looking back, I’m sure the surgeon who removed the lump could tell there was something wrong.

I’d had so many follow ups in clinic during the five years before that had come to nothing so I thought I knew what I was doing. The clinic ran late and when I finally got called in for the appointment I was asked to change into a hospital gown. I was on my own and the surgeon came in followed by a lady who I later discovered was a MacMillan) and I knew something was really wrong.

My memory of this meeting is a somewhat hazy. The surgeon examined my neck and arms for any other lumps. Looking back he was probably looking for any swollen lymph nodes. He asked if I had brought anyone with me to the hospital as I was on my own. I was told the lump was melanoma and it had spread from my original mole five years earlier. I was then swiftly booked in to an appointment with an Oncologist specialising in melanoma at Northampton General Hospital the next day. I’ve now been seeing the same Oncologist for nine years. That’s 3287 days!

Subsequent MRI and CT scans showed a single lung tumour and a single brain tumour. In the month that followed I went from being a seemingly well 23 year old graduate to a stage 4 cancer patient, registered disabled and unable to go to work, and facing the very real prospect of an imminent departure from the world. Talk about life throwing me a curveball

I am certainly not a statistic and me being alive and well and writing this post it as close to a miracle I will ever get. For me, September is a month full of various triggers and cancer related anniversaries, but October is just the same, closely followed by Christmas and Birthdays as well as Summer time, so in effect the whole year.

I have spent the past 14 years of my life as a cancer patient and next year marks a decade as a stage 4 cancer patient. Its a life sentence and some days I find the whole situation beyond comprehension. Being focussed on the now is much easier said that done with cancer demons floating above, ready to pounce at any time.

I was told upon diagnosis in 2010 that people with my type of cancer at such a late stage lived for an average of 18 months. There have been numerous points over the past few years when I truly thought that I wasn’t going to make it for much longer. It’s looked very bad for me numerous times and I know my family felt it too. I’ve been on sick leave from work and had to come to terms with the fact I might never go back.

Three and a half years ago I was in hospital, having had surgery to remove cancer from my bowel for the second time. I had hardly any hair of my own, and I was unrecognisable from my ‘old’ self. Now I look like the 2010 version of me, with a full head of hair and most of my cancer scars covered up. On the outside I look the same, but I am a whole new version of myself compared to nine years ago. My twenties were really exhausting and stressful, and I feel like I missed out of so much, relationships, work opportunities and generally having fun. So far the first 2 years of my 30s have gone better than the majority of the last decade. I am treatment free and my oncology appointments are currently kept to a minimum. I hope cancer continues to lay low and not dominate the next decade of my life. My world has been turned upside down but I’m living on the flip side and that seems ok for now. Keeping everything crossed for my scans in two weeks.

September Sadness

This month has gone very quickly, having been away on an exciting work trip to Japan I am now back in the real world. My three year blogging anniversary took place whilst I was away. The past year has been the most significant as I stopped taking Immunotherapy drug Pembrolizumab, having had my last infusion in December 2018 and my last major surgery during the summer of 2016.

September is also very significant as it marks exactly 14 years since I was initially diagnosed with stage 1 melanoma aged 18. I have now been living as a stage 4 patient for almost 9 years, with the end of next month marking the date I was told my diagnosis was Stage 4 cancer and I had to have two major operations to remove a lung tumour and brain tumour which had been growing inside me during my final year at University.

September is a month full of various triggers and cancer related anniversaries, when I was diagnosed in 2010 I thought I may not make it to 24 or 25, and now I’m 32! I woke up this morning, or in the middle of the night with it being 4am, still jet lagged from my long flight home. My work trip and travelling bubble has well and truly burst. For me, September is full of sadness and so many bad memories which have changed the course of my life forever. In this case i’m not sure if the memories fade or that time heals old wounds, but it really doesn’t feel like it today! My wounds are sore and as raw as ever right now.

I try my best not to think about the more distant future, but no matter how much time passes I still feel like I am looking down the barrel of a loaded gun every day, being away from London and my ‘normal’ life allows me to switch off a little, and there is a sense hope. Travelling home I started to think about my next long haul trip to America in 2020, and I am trying not to panic that something dreadful will happen between now and then which means I won’t actually go.

I am due a PET CT scan within the next month, and am awaiting a date for my MRI scan too, and will get the results at the start of November. I am starting to worry now that I know the date, particularly with the recent news about the hot spots of my last scan. Today I am full of misery and fear about what could be.

I’ve only been home five minutes but my mind has started experiencing certain triggers that are very distressing. This morning I discovered some hair in the shower plug hole and although this is totally normal I immediately had a flashback from when my hair started falling out about five years ago. September is a month when I think about my diagnosis and the impact it has on my life even more. I really hope October will be easier!

Summer Scan Results

A month ago I had my second PET CT scan since adopting a surveillance approach to my treatment for stage 4 melanoma. Like last time, I had to wait almost a month to see my consultant for the results. Yesterday I saw my team in Leicester an am happy to report that for the most part all has remained stable, which is cause for a celebration.

Annoyingly, I have been told there are a couple of very small ‘hot spots’ which were present on my most recent PET CT scan, one in my arm and another at the back of my throat / nose.

My Oncologist suggested there was no cause for any immediate concern, which is great, however I’m a bit thrown by these small spots appearing on my scan! I feel physically well and expected the results to continue to show no evidence of disease (NED), so the fact this isn’t quite crystal clear means I’ve been caught off guard. I’ve been riding the NED wave for some time now, so I’m disappointed.

I was offered the option to be referred to an ENT specialist to investigate this further, but my Oncologist felt this unnecessarily so I decided to trust his judgment. I’m also still enjoying the freedom of having very few medical appointments and I’m not keen to start adding to the load again unless it’s 100% necessary.

A PET CT scan doesn’t diagnose cancer itself, so It is very likely that the hot spots might have been caused by other factors such as a blood test / injection or even a cold.

The current plan is to carry on without treatment and take a look at my next scan in a couple months and act then if there is any reason to. It’s feasible that these spots will have disappeared by then, and no further action will be needed, but it’s certainly freaked me out a bit. I guess this is the nature of being on ‘watch and wait’.

In other good news, I’ve been told that all being well we can discuss the possibility of getting my portacath removed once I’ve been off treatment for a year.

For the most part my glass remains more than half full, something I’ve been trying to tell myself over the last year or so. There are plenty of adventures planned before I have both an MRI and PET CT scan in October, so hopefully my mind will be occupied.

Scan Results And Festive Freedom

Yesterday I received results from my last PET CT and MRI scans and I’m relieved to say that the results were good and everything continues to be stable.

After getting over the Scanxiety, I was feeling somewhat confident that the results would be stable, however the worry is never too far from my mind. Hopefully this means I can relax a little over the Christmas and New Year period.

I am fortunate enough to be having a chemo break and am not due back to see the oncology team at my hospital in Leicester for another six week. In my 2 and a half years of receiving Pembrolizumab this is a rare occurrence, and one I am especially grateful for at this time of year, fingers crossed this will be a blissful time of freedom over the festive period.

I haven’t written a blog post since The Truth About Depression three weeks ago. Part of me has been living in purgatory waiting to get my scans over and done with, and the other part has felt like I’ve not really got anything more to say. I haven’t suddenly snapped out of my downward spiral, but I am taking more steps to try and help myself.

I have now had my 41st cycle of Pembrolizumab and the fatigue seems to be hitting me more than ever. Lucky I have been working from home and resting which always helps, but powering through never feels like an option when it comes to post treatment tiredness. This is something I didn’t appreciate before I started having Pembrolizumab. A while back I wrote a post called Tired of Being Tired, which summarised my feelings on being physically and mentally exhausted. After reading it back, I feel the same as I did back then, annoyingly getting used to it doesn’t make me feel any less exhausted.

Exhaustion comes in waves, and when it hits it seems to affect my energy levels straight away. There is something about being in a hospital waiting room which makes me feel so sleepy, even with all the alarms and buzzers going off every few minutes. Having the treatment itself makes me become a total zombie, and I often struggle for a few days afterwards, making small things such as walking up the stairs or packing a bag seem like a huge struggle. I don’t trust myself to drive after chemo as my judgement certainly isn’t what it should be. I long to feel free and full of energy again, so perhaps having a treatment break over Christmas is exactly what I need.

A couple of people have asked me if I planned to celebrate my stable scans results. A few years ago I used to mark them as more of an occasion, but I honestly don’t think about them as a moment to jump up and down for joy. Nowadays I am too scared of what the future holds and I’ve been feeling particularly vulnerable over the past couple of months.

Of course I am so grateful to be in this position, even if living with cancer does take its toll, but I prefer to try and reset my mindset to one that isn’t in complete panic mode. I want to try and look forward to the next few months rather than just celebrate one moment. Hopefully I will feel less like I’m holding a poisoned chalice and perhaps as though I am holding a glass half full instead.

Fingers crossed for more good news in 2019. Until then I need to go back to sleep, rest and try to fight off a cold I think is coming my way as I’m a bit under the weather.