Woman, 69 years old, colorectal cancer
I first met cancer in 1995, when I was discovered ovarian cancer. I underwent surgery and chemotherapy. For all these years I took proper care of my health and underwent the necessary check-ups. Since I had been through this hell once I hoped that the cancer would not come back, but it did – this time in a different form.
In autumn 2015, I felt excessive weakness and sever stomach-ache. In the beginning of November, when having a recurrent pain attack I was taken to hospital by an ambulance and had the gallbladder removed. Only a month after the surgery the pain returned, diarrhoea alternated with constipation, I felt sick and had a fever – I had to call the ambulance again. At the hospital I was examined, they took blood test and carried out computed tomography of my stomach. Having evaluated the results of the tests, the doctor had suspicion of bowel inflammation – a course of antibiotics was prescribed and I was discharged from the hospital.
However, I returned soon, after having a recurrent attack of stomach-ache. I understood that my health condition was severe and that antibiotics alone would not help. I decided that I need to consult doctors in Riga, so this time I left the hospital on my own responsibility and scheduled a visit to a gastroenterologist at the Pauls Stradiņš Clinical University Hospital. From this moment onwards everything went very fast – a visit, tests, computed tomography of the stomach and on the first days of 2016 I was already on the operation table. During the surgery I had a part of the large intestine removed, which had both an acute intestinal obstruction and, as confirmed by histology later – a tumour. Oncologists’ council at the hospital prescribed 6 post-operation cycles of chemotherapy.
Following the chemotherapy I started to recover and really hoped that I have got rid of the cancer. But in October 2016 control tests showed high tumour market levels and the test results were also beyond the normal range. I am quite competent in various examinations as I come from a family of medical practitioners, my sister is a doctor, therefore I knew about PET/CT long ago, the one thing I did not know was that the method was available in Latvia. I was collecting money to go to St. Petersburg or a clinic in Europe, or to my daughter in Dublin. I had been ordered magnetic resonance and computed tomography examinations in Riga, but then suddenly I came across an article on the Facebook on PET/CT examinations in Riga. I put MRI and CT aside, got PET/CT prescribed and arrived at "Nuclear Medicine Centre".
I am convinced that cancer can be successfully treated if you have precise information about it, so you do not have to shoot sparrows with cannon and waste the already scarce national funding. To ensure precision of the diagnosis, I had my tissue sample taken for a gene mutation analysis, and I was sure that the PET/CT examination would give me a full picture of my body and precise data on the tumour spread.
After the PET/CT examination I found out that the prescribed chemotherapy had not been effective enough and there were focal points in my stomach that had not disappeared. When I received images of the examination I sent them to St. Petersburg to get a second opinion. The conclusion drawn by Russian doctors was the same and they confirmed that the examinations carried out by "Nuclear Medicine Centre" were of high quality.
Taking into account the results of the PET/CT examination, the scheme of my chemotherapy was changed completely and a more efficient form of treatment was selected. Although the second chemotherapy was physically harder I think it hit the tumour much more precisely than the initially applied standard therapy. I am sure that I will carry out a repeated PET/CT examination to control efficiency of the therapy.
I have been sure of the importance and necessity of this method, unfortunately there is still little knowledge about this method and it is not subject to national funding. I have been telling about PET to other people; and following my recommendation a friend of mine has undergone PET scan as well. I would recommend PET/CT to all patients who have completed cancer treatment and have concerns regarding the cancer coming back; it is also an excellent tool for testing the efficiency of the prescribed chemotherapy.
After the PET/CT examination I found out that the prescribed chemotherapy had not been effective enough - there were focal points in my stomach that had not disappeared.
Comment of a radiologist-diagnostician
“The patient had undergone 6 cycles of chemotherapy, but she felt good; nevertheless, since the tumour markers had increased it was necessary to assess the efficiency of the applied therapy. The patient had a whole body PET/CT examination using 18F-FDG which allowed us to collect all the necessary information by carrying out a single examination – about bones, soft tissues and organs. During the examination two focal points of metastases with intensive metabolism were diagnosed in the patient’s stomach.”