DAY 451 - Day 354 in Recovery Paradise

Woo - Hoo - just 4 more years and I just might win...

Thanks to my sister Sharon Chamberlin, I took my 62 Birthday Cancer-Victory Hot Air Balloon ride last weekend with my wife, Lise and my daughter, Sarah, out of Windsor, California. It was quiet, peaceful, and unforgettably beautiful. Nice soft (really soft- like stepping slowly off the bottom step of a set of stairs on to thick cushy carpet) landing in a field about 10 miles from where we launched...chase vehicles followed the flight. Followed up with a commemorative flight pin and certificate and a quiche-champagne breakfast in the vineyards of Kendall-Jackson Winery.

CT result

To:

Robert L Welton

From:

NATHALIE TUYET-NGOC NGUYEN MD

Received:

8/25/09 9:41 AM

Dear Mr. Welton,

Your CT scan results are attached below. It looks like you've responded well to treatment. Please let me know if you have additional questions.

Regards,

Nathalie T. Nguyen, M.D.
Radiation Oncology

CT HEAD AND NECK WITH CONTRAST

** HISTORY **:
Left-sided tonsillar cancer status post treatment.

Comparison: Recent PET/CT from 8/2/2009, prior PET/CT from
6/15/2008.

** FINDINGS **:
Technique: Axial images of the head and neck were obtained after
administration of Visipaque, hundred cc.

Significant artifact is identified related to the dental hardware.
However there is significant improvement with complete resolution
of the previously identified left level 2 lymph node which
measured up to 2.5 cm in the prior examination in maximal short
axis dimensions.

Additionally there is less mass-effect in relation to the left of
the with no definite enhancing mass in relation to the left of
the. However there is mild asymmetry in the soft tissues in
relation to the base of tongue on the left side along the anterior
margin of the left tonsil. (Axial image number 37). This likely
represents posttreatment changes. No corresponding metabolic
activity was identified in the recent PET - CT scan in this
region.

Significant mucosal disease in the left maxillary sinus with
mucosal thickening. Mastoid air cells are clear. Minimal mucosal
disease noted in the right maxillary sinus is well. Evaluation of
the lung apices is unremarkable. No significant lymphadenopathy
noted. The region of the supra, infraglottic larynx, epiglottis
is grossly unremarkable. The parapharyngeal fat is normally
preserved. The deep spaces of the neck are unremarkable.

** IMPRESSION **:
Significant improvement when compared to prior PET/CT from
6/15/2008 and findings in the current contrast enhanced neck CT
are concordant with the recent PET CT report from 8/2/2009.

2. Interval complete resolution of the left-sided level 2
metastatic lymph node. There is no interval development of any
new foci of lymphadenopathy.

3. There is limitation of evaluation of the oral cavity secondary
to significant dental artifact, however there is less mass effect
along the left base of tongue, and left anterior tonsillar pillar
when compared to prior examination suggesting significant
improvement. There is no residual enhancing mass. Posttreatment
changes are noted in this region.

4. mucosal disease along the maxillary sinuses bilaterally left
more prominent compared to the right.


LAVANYA KALLA MD

DAY 450 - Day 353 in Recovery Paradise

Have been following the tonsil-cancer-support@googlegroups.com blog and there seems to be a never-ending flow of other souls coming down the long hard road of dealing with tonsil cancer. Lots of people in their 50's being affected. Must be a connection there. Perhaps it was the lifestyle of the 70's?

Had a CT Scan last Monday - but no posted results. I am hoping it is just as a benchmark for my schedule to have them every 6 months for the next 4 years. I still have a constant sore throat, but my sinus issues seem to be going away. I was free of throat issues there for a few months and it seems to have come back within the past two months. I have grown used to it, so I don't think about it much. There is another guy at my work that is a brain cancer survivor and another young guy at my work who just went through a testicular cancer scare this past week.

The biggest gift I received from this experience is to place a better perspective on what is really important and I can assure you it is not "things"...although I admit, guiltily, I did delight in treating myself to repainting my 2006 PT Cruiser the color I always wanted for my birthday. My renewed and re-energized goal is to be a better husband, better father, better brother, better friend, better person to those around me.

He who can no longer pause to wonder and stand rapt in awe, is as good as dead; his eyes are closed......
Albert Einstein

Song of the Day: Eric Clapton - Tears in Heaven

DAY 431- Day 334 in Recovery Paradise

PET results

To:

Robert L Welton

From:

NATHALIE TUYET-NGOC NGUYEN MD

Received:

8/5/09 4:07 PM

Dear Mr. Welton,

Below is PET/CT scan result. All looks favorable. Please let me know if you have additional questions.

Regards,

Nathalie T. Nguyen, M.D.
Radiation Oncology


PET/CT

** HISTORY **:
61-year-old man with a history of locally advanced squamous cell carcinoma (head and neck) status post chemoradiation completed October 2008.

** FINDINGS **:
DOSE: 14.3 mCi FDG (2-fluorine-18-fluoro-2-deoxy-D-glucose) ADM: IV

Comparison is made with 06/15/2008. The fasting blood glucose was 119 mg/dl.

Approximately one hour after injection of the radiopharmaceutical, the patient was imaged from the top of the brain to just beyond the inguinal region in 7 bed positions. For each bed position, a
four-minute emission scan was acquired. A CT scan of the same regions was performed. Please note that the CT portion of this study is a relatively low dose multi-slice scan without IV
contrast, intended only for attenuation correction and anatomic correlation of PET data. It is not an independent diagnostic study with respect to the clinical indications. Data were analyzed as a
whole body rendering using cinematic display and in the transaxial, sagittal, and coronal planes for slice-by-slice review.

Physiologic FDG distribution is seen within the brain. The two intensely hypermetabolic lesions in the left tonsil and the left superior jugular lymph node seen on the comparison PET scan are no longer identified. There is asymmetric low grade increased FDG activity about the left side of the neck, characteristic of chronic post radiation inflammatory changes rather than neoplastic disease. Distribution of FDG within the remainder of the head is unremarkable.

There are no suspicious hypermetabolic foci within the axillae, the thorax, abdomen, pelvis, with visualized portion of the musculoskeletal system. Normal FDG excretion is seen within the
genitourinary system.

** IMPRESSION **:
Foci of abnormal FDG activity are not identified that would suggest residual squamous cell carcinoma. Minor chronic post radiation inflammatory changes are suggested in the left side of
the neck.

Woooooooo Hoooooooo

DAY 430 - Day 333 in Recovery Paradise

Had my first PetScan in a year last Sunday at 7am at Kaiser Hospital. This is a test to see if the cancer cells have returned. With a PetScan you first have an injection of a very small amount of a radioactive drug. The amount of radiation is very small. It only stays in the body for a few hours. Depending on which drug you have, the radioactive drug will travel to particular parts of your body. The most common drug is fluorine 18, also known as FDG-18. This is a radioactive version of glucose. I should know the results this week.

I am scheduled for a CTScan on Monday the 17th, at 8am at the same hospital. CT scanning combines special x-ray equipment with sophisticated computers to produce multiple images or pictures of the inside of the body.

I have had three visual checks of my mouth, tonsils and throat and everyone said it looked fine. I, however, have had this pestering sore throat for about two months that just won't go away. That is exactly how this whole thing began over a year and a half ago. I am concerned, but will know soon. Am hoping for good news.

When I was down (but not for the count) last year, I had mentioned to my sister that I had regretted not having gone on a hot air balloon ride. For my birthday last year, she got me a certificate for a Hot Air Balloon Ride with Up & Away Balloon rides over the Napa Valley. I have had it on my wall for a year, waiting for the opportunity and good health to give it a go. We now have our trip scheduled for August 16th. I should have my PetScan results back by then. It will be a fantastic trip no matter what.