So who is this Peter that we speak of…let’s talk about Peter…his full name is Peter the Pesky Pelvic Lymph Node (PPP) for short.
When I had scans at Mayo, they did see an enlarged lymph node in the pelvic area. I asked what we needed to do about that – this was before the sarcoma surgery – and the surgery team said “well you have had cancer before…” LOL kind of a strange response, but I thought it meant that is on the back burner for now. It did show up on various scans including the PET at Mayo, but again not a topic of discussion at Mayo.
Go forward to after surgery and I first had a CT scan at Methodist and there PPP was seen on the scan, but seemed to have gotten smaller in size, which was great news. So the focus was on Larry and getting him out of the neck and seeing what he was. They did determine that Larry was Lymphoma (Hodgkins Lymphocyte Predominate), but Dr. Chen wanted to do a bone marrow biopsy and a PET scan to make sure Larry had not spread his happy lymphoma germs into further areas.
Bone Marrow came back fine, but PET showed that now PPP had grown in size and he was “active”. Apparently “active” can only be seen on a PET and that caused more concern that the increase in size. I had a conversation with Dr. Chen Tuesday night and she wants to have a needle biopsy on Peter the Pesky Pelvic Lymph Node…LOL I did express to her my being skeptic of needle biopsies, considering the neck one did not show the lymphoma and neither did the lymph node they needled 15 years ago! She did say that with the neck they could only do limited biopsies and had to use a smaller needle so could not get a “core biopsy” which provides more cells to look at. They did not do that core in the neck because the lymph node was too close to critical arteries and they did not want to risk using a bigger needle. With trying to biopsy PPP, they should be able to get a core biopsy and enough that can get a good reading.
I said to Chen even if PPP comes back as negative, are you really going to trust that it is truly NOT lymphoma knowing the needle biopsies can be flaky sometimes. She said she agrees that she may not trust a negative result, but since PPP is on the left side, same side as the sarcoma surgery, the risk of doing surgery to remove the lymph node could potentially cause some issues. So she wants to do the needle first and hopefully we can see if Larry did some lymphoma influencing with PPP before he got removed. That sneaky Larry the Lymph Node!! Larry was just the gift that kept on giving!!
So the needle biopsy is tomorrow (Thursday) at Methodist. The nurse called me and said they would also be doing sedation and pain meds via IV, so I guess PPP is even more troublesome than Larry was. With Larry only local sedation was used. But hopefully they will give me the good stuff tomorrow and I can just relax. Oh boy, another morning of NO coffee!!
Dr. Chen did say that after these results she would probably have me come in to the office so we can discuss the treatment plan. Most likely it would be Rituxan which is done by infusion, or if PPP is negative and she feels confident with that conclusion than it may only be radiation.
There are some interesting insurance guidelines on getting Rituxan, but I will leave that little rant until we find out if that is being used.
So sounds like we have a good plan going forward, although having the biopsy tomorrow, close to the weekend may mean another long wait to hear results. But as I have said I have become a professional “wait-er”. 🙂
Take care and enjoy the great weather here in MN — 70’s for the weekend!!!
Smile!
Dandy Ventures 