Having already recently gone through a CT scan with contrast, I wasn’t overly apprehensive about the PET/CT scan. In fact, the biggest issue for me was not being able to drink anything other than water until after the procedure that was scheduled for late in the morning. Being an avid coffee drinker, this was quite stressful! I was brought to a room where the radioactive injection was administered and then waited approximately an hour for the drug to circulate before being scanned. This was a much longer procedure than the original CT scan and took around 2-hours total. By now, I was familiar with the online patient portal that provided very quick results from imaging studies performed at St. Mary’s. By mid-afternoon I was able to read the radiology report online. The report indicated that the cancer likely originated in my right tonsil and had spread to nearby lymph nodes.
This is the point where having a background in oncology is both a blessing and a curse. I knew that “staging” describes the severity of a person’s cancer based on the size and/or extent (reach) of the original (primary) tumor and whether or not cancer has spread in the body¹. This is important for several reasons:
- Staging helps the doctor plan the appropriate treatment.
- Cancer stage can be used in estimating a person’s prognosis.
- Knowing the stage of cancer is important in identifying clinical trials that may be a suitable treatment option for a patient.
- Staging helps health care providers and researchers exchange information about patients; it also gives them a common terminology for evaluating the results of clinical trials and comparing the results of different trials.
As a tumor grows, it can invade nearby tissues and organs. Cancer cells can also break away from a tumor and enter the bloodstream or the lymphatic system. By moving through the bloodstream or lymphatic system, cancer cells can spread from the primary site to lymph nodes or to other organs, where they may form new tumors. The spread of cancer is called metastasis. In view of the fact that my cancer originated in the right tonsil, I knew that based on the PET/CT imaging results it had already spread from the primary site to the lymph nodes (not good).
Using the oral and oropharyngeal cancer staging criteria for tumor (T), node (N), and metastasis (M), also known as TNM, I had stage IVA cancer of the tonsil due to the fact that the enlarged lymph node measured more than 3cm and/or may be in more than one lymph node².