“The images obtained during the examination showed something like two small fireflies glittering against the dark background,” Sintija tells.
After a tiresome cycle of chemotherapy she was looking forward for long-awaited news that the malignant tumour in her breast has disappeared. The reality was quite different. “I am glad that I listened to my husband and underwent PET/CT examination. Due to that I continued treatment and now I feel well,” adds Sintija.
She was saved because of being careful…
She received the news of the full recovery almost two months ago after repeated PET/CT or combined positron emission tomography and computed tomography examination. PET/CT screening is available at the oncological disease diagnostics centre "Nuclear Medicine Clinic" and as for today it is the most precise method for determining whether the cancer has been cured or not.
For the first time, she underwent this kind of examination not long after she had completed the chemotherapy treatment.
“My husband and my parents insisted on undergoing this examination. Yes, the blood test results were good, but me and my husband we had a kind of anxiety. We thought that I must be well after the dose of chemotherapy I received, but the voice inside me did not let me be. I could have used another method for control examination, but my relatives insisted on this one, as PET/CT examines the whole body. And good for me!” Sintija is glad. She accepted the money gathered by her husband, parents and friends and went to have the examination that should finally clarify the situation and give peace. “I got the answers, but the peace was gone for a while,” she tells: “The images clearly showed that the chemotherapy had not been able to cope with two small metastases close to the armpit that was confirmed in biopsy later. They had to be operated soon.”
As the PET/CT showed a precise location of the malignant cells, the operating surgeon removed only the affected tissues. The council of doctors decided that no repeated cycle of chemotherapy was necessary; it would be enough with the radiation therapy, which is a more cautious method. The repeated PET/CT examination performed at the end of autumn confirmed – the method chosen by the doctors was correct and no future formations of malignant cells were found in her body.
“Of course, the examination is not cheap, but it is invaluable. First of all, my doctor saw the precise location of the bad cells and removed only them. Secondly, I am now truly sure that I am well. And thirdly I felt the care and sincereness of my family and friends, who gathered the necessary amount in just a couple of days for me to be able to have the examination,” Sintija’s voice breaks while telling, but her eyes are filled with immeasurable joy and gratitude. She adds: “I think all cancer patients must undergo this examination – both due to the precision of diagnosis and peace for themselves.”
What is the difference?
Sintija had read that already for a while it is possible to have PET/CT or the combined positron emission tomography and computed tomography examination in Latvia, which - on the contrary to other types of visual diagnostics that they discover tumours by visual changes in tissues - is able to assess the functional nature of the tumour. In other words, PET/CT shows the behaviour of the tumour – whether it is benign, malignant, how active and aggressive or on the contrary – how inactive it is.
How is it possible?
Sintija tells: “I was injected glucose intravenously that is marked with radiopharmaceutical substance, which resembled a simple solution. Cancer cells are like sugar therefore they consume glucose more actively than healthy tissues. Glucose spreads through the body and most intensively is absorbed by the focal points of the cancer. In about an hour after the injection I had the examination – the computed tomography and right after the positron emission tomography. The examination itself took a bit over half an hour…”
Doctors frequently suggest PET/CT to lymphoma patients, as these tumours tend to spread all over the body. If you know from the beginning that there are cancer cells in the lymphatic tissues it makes the choice of the most suitable treatment method much easier. Regular post-treatment check-ups are also crucial in order to make sure that the disease has not returned or in case it is necessary to start timely treatment.
“At first, I was afraid whether I am not dangerous to my family due to the injected radioactive substance, but the doctor calmed me down, saying that the PET examination is a very low-risk procedure. The radiopharmaceutical substance injected intravenously is tolerated easily – it does not cause allergy, fever, sickness or vomiting. Besides, the radioactive emission does not stay for long in human body. A part of the injected medication stays in the room where I waited for the procedure and in WC. The level of the remaining radiation decreased rapidly during the examination,” Sintija recalls what the doctor told her.
When attending the examination for the second time she did not worry about any possible harm to herself or her close ones.
“The main thing I was thinking about – to get the results of the examination as soon as possible and be sure that I am well!” Sintija says.
Fear that the cancer would return
When Inta, who recovered from breast cancer three years ago, found out about the experience of her friend, she also decided to have this examination. She says: “I still have regular visits to my doctor, take blood tests, including tumour markers, but I still have worries all the time – am I really well? Particularly at times when the operated breast hurts for any reason whatsoever. I know that this can happen and that it is a normal process. I know that the fear of the cancer returning is understandable, but it is really hard when these thoughts thrust on me. The experience of Sintija was something new to me, as I was not aware of this examination. I decided to spend my savings for it. After the examination, I obtained the long-awaited peace – there is no cancer in my body.”
A friend of Sintija tells that she has decided to undergo a repeated PET/CT scan in about another three years to make sure that the cancer has not returned. She is saving for that, although she hopes that it will be a State-funded examination. “Not everyone is able to put a side something from their salary, but I think that the health budget would only benefit from inclusion of PET/CT on the list of the State-funded examinations. Patients would receive suitable treatment and thus the money spent for unnecessary medications would be saved, moreover, patients would not be poisoned with chemical substances and could return to work much faster, earn money and pay taxes,” she thinks.
The cases, when the examination is applied
In around 90% of the cases PET/CT examination is used to diagnose cancer. In most cases PET/CT is used for Hodgkin lymphoma and Non-Hodgkin lymphoma, breast cancer, colorectal and lung cancer, prostate, uterine, cervical and ovarian cancer, stomach and oesophageal cancer, pancreatic cancer, melanoma and sarcoma, as well as in cases when looking for a cancer of unknown localisation, etc.
PET/CT ensures early assessment of the efficiency of the chosen treatment method. It is not necessary to wait for the survived cancer cells to multiply to amounts that are visible by methods of visual diagnostics. Precise and early diagnostics allow more precise treatment and avoid excessive doses of medications if it turns out that the cancer has been stopped, or avoid intake of medications not suitable for the particular type of cancer and selection of proper and effective medical treatment. A precise treatment plan reduces side effects and costs of unnecessary therapy and improves the possibility of efficient recovery.