Day 34 - PET scan results

This morning I got up early, and got ready to go visit my Oncologist.
My car would not start. The solenoid on the starter seems jammed. I even brought out a battery from my solar system and tried a jump start. I ended up taking a Taxi to the hospital, and I walked home. 8.0km.  I will need to waste time, and money, looking for more reliable transport.

I am just back from my appointment with the oncologist.
She says the Pet scan results show no indications of any cancer other than in my left lower leg.
While not having any metastasis yet, is a good sign. Of all the news possible from the PET scan, this news is the best. But for some reason that isn't as comforting as I had hoped. 

I will have chemo for 12 weeks starting Tuesday. The chemo will be for two reasons.
One reason is, so that any new cancer that starts, is in a chemo rich environment straight away.
The other reason is as a neoadjuvent. A neoadjuvent is a procedure done before another main procedure. In my case before surgery. The neoadjuvent chemo will be to try to shrink the tumors, so the surgeon can better find and remove all the tumors in my leg.

She was unable to answer most of my questions.
I asked if this cancer will be the cause of my death. She said that right now I am healthy. If the cancer never spreads, then I will not die from this cancer. But Angiosarcoma is very fast spreading, and aggressive. What we have today, may not be what we have next month.

I asked how often we will check the spread of the cancer. She said that we can do CT scans of the leg at regular intervals, but Pet scans are very radio active and they will not be used so often. She said to plan on a CT scan after every course of chemo. +-12 weeks.

I asked about amputation. She said that it would help little as Angiosarcoma is carried by the blood from a tumor. I have many tumors on my leg. Each could have sent hundreds of cancer cells throughout my body already. Removing the tumors now, will help reduce any more cells being spread, but will not reduce the ones already spread.

I asked why not use Immunotherapy instead of chemo. She said that Immunotherapy has to first have a tumor to fight. I have none outside my leg and surgery should remove all the ones in my leg.

I asked if chemo will be able to kill all the cancer. She said the purpose of this treatment is only to try to slow down the rate of metastasis, or spreading.

I asked about the surgery. She said that it depends on the effectiveness of the chemo. The surgery and skin graft may require a hospital stay of 5 days. Followed by 2 weeks of keeping all weight off the leg, and keeping it elevated at all times. Probably in a wheelchair.

I have been reading up on Angiosarcoma more.

Angiosarcoma is a rare, malignant subtype of sarcoma that originate in blood vessels and the linings of various blood-filled sites throughout the body. This sarcoma subtype is an aggressive cancer with a strong tendency to recur locally. Furthermore, this cancer often spreads quickly throughout the body. Prognosis is usually poor.

The most widely known cause of angiosarcoma is lymphedema, the swelling of an area of the body due to the collection of fluid.  (My leg was swollen for 33 years after the scorpion sting.) 
 It can look like a skin infection, a bruise or a lesion that does not heal. It may have a violet colour. Deep-seated tumours may go unnoticed until they begin to affect surrounding tissues and organs. (This was my case for about a month before the sores broke out.)

Angiosarcomas develop so gradually that they are often well established by the time of diagnosis. Diseases such as this are defined by the term insidious. Furthermore, this sarcoma subtype does not respond well to most traditional  treatments such as chemotherapy, radiation therapy, steroid administration. The combination of aggressive growth, few treatment options, and extreme rarity makes angiosarcoma one of the deadliest cancers.

A good metaphor is that of a factory sitting on the edge of a river. When the factory (the sarcoma) outputs toxins into the river (the bloodstream), they don't stay near the factory. Instead, they affect areas further downstream. In the human body, cancerous cells can split from the angiosarcoma, and travel quickly to all parts of the body by using the high-speed circulatory system. If several cells split from the tumor, they can form tens or even hundreds of tiny, nearly undetectable tumors all over the body. These tumors are extremely difficult to treat, and can often be fatal.

Most treatments of this cancer are not intended to be curative. Medications are often prescribed to reduce symptoms such as fatigue, anemia, and pains. Various surgeries are usually performed to promote a healthy appearance and a more comfortable day-to-day life for the patient.

So...Am I glad I don't have any cancer anywhere but in my leg? Yes I am, because this mean, that this cancer will probably not kill me.....this month.