Tuesday, April 5, 2016

Metastatic Squamous Cell Cancer

I noticed the lymph nodes in my neck were swollen starting in Dec 2015, but it came and went.  I mentioned it to Dr. Teng during my Feb 15 2016 appt.  She scheduled an ultrasound on 18 Feb which confirmed that they were enlarged.



FINDINGS:
Ultrasound of the palpable areas on the left neck are consistent with multiple enlarged lymph nodes. There is loss of the normal morphology. Largest of these in the left lateral neck is measured at 2.4 x 1.1 x 1.7 cm. There are at least four of these present. The right lateral neck shows no adenopathy

Next was an appt with Dr. Buzad, a surgeon who did a biopsy on 30 March to remove one of the swollen lymph nodes.  That is what gave the diagnosis of "Metastatic Squamous Cell Cancer".  The problem is that the cancer cells had metastasised from the primary site into the lymph nodes, so the goal is to find the primary site.

Since the affected lymph nodes are in the neck, the assumption is that the primary cancer is in the upper body.  The "Squamous Cell" determination says that the primary cancer will be on a membrane -- skin or an inside surface.  I had a skin check-up on 3 Feb, and nothing was found, so it must be an inside surface.

That leads to a 5 April appt with Dr. Hewitt (ENT).  She checked my mouth and throat, and used a scope to look down my nose into my sinuses and my throat, and found nothing.  Which leads to needing a better scan of a larger area -- a CT scan of my upper body, scheduled that afternoon at 3:00.

The CT scan went as expected.  Go in, lay down on this "bed" and it gets moved back and forth thru a large ring of a machine.  Try to lay very still with your head and neck just so.  Breathe.  Hold it.   Back and Forth, then you can breathe again.

I stuck around for another 30 minutes after the scan, and they made a CD of the images for me.  The disk says there are two CT scans, 662 images.  It appears to also have an executable of something called GearView which is a Windows program to display the images.  There are PDF user manuals in English, French, Spanish, German, and Portuguese.

They said the CT scan images would be "read" by a radiologist and the report sent to Dr. Hewitt.


There is also a file saying to use OsiriX Lite on an Apple system.


The files themselves seem to be in a directory called DICOM as file 1, 2, ..., 662.