I have been through two of six cycles of chemotherapy. So far I am tolerating it well and have minimal side effects. Honestly, aside from the hair loss I have fatigue and a tiny bit of peripheral neuropathy.
So how do we know it is working? I asked this question after the first round of chemotherapy. The answer was 1) you will feel better and 2) we will repeat the PET scan so we can measure the progress.
Yesterday I had the repeat PET scan. And we are making progress!
From the original PET scan:
Large intensely FDG avid approximately 6 x 11 x 12 cm (AP, TRV, CC dimensions) in the anterior mediastinal/level 3 soft tissue density mass resulting in moderate mass effect and displacement of the heart and great vessels. Relatively homogeneous tracer uptake, SUVmax = 25.
From the second PET scan:
Interval significant decrease in size to known anterior mediastinal mass with heterogeneous and discontinues moderate to intense peripheral tracer uptake, SUVmax = 6. It measures approximately 2.8 x 6.4 x 7 cm (AP, TRV, CC dimensions).
Now for a little math (assuming an ellipsoid shape)…
The original volume of the mass (aka tumor) was 6cm x 11cm x 12cm = 3317 cm3
The volume of the mass now is 2.8cm x 6.4cm x 7cm = 525 cm3
This means that the mass has lost 85% of its original size. And it is not as bright now as it was in the first PET scan (probably not the correct terminology).
I am not done. I still have 4 cycles for chemotherapy to complete and as long as my white cell counts stay high enough they will increase the dosage of the chemotherapy each round. But now I know the treatment is both the right treatment and it is working!