CT Scan

PET/CT scanI’m not usually claustrophobic, but even the open nature of the CT scan made me a bit uneasy.  The CT involved iodinated contrast, which is a form of intravenous radiocontrast (radiographic dye) containing iodine to enhance the visibility of vascular structures and organs during radiographic procedures.

Immediately following my CT scan, I received a CD with the results.  In view of my background with radiopharmaceutical companies – I loaded the CD in my computer to try and peak at the results.  Unfortunately, the CD was only for Windows computers and I only had access to a Mac. Nonetheless, I had a general idea of what wouldn’t be a good sign – such as a dark center in the enlarged lymph node, which could indicate necrosis.

Initial Visit with ENT

endoscopeThe antibiotics did nothing to alter the size of the lateral neck mass, which prompted a visit to an ENT.  At this point, I was 100% convinced that I had cancer based on everything that I read.  The only question was what “type” of cancer and its stage.  After spraying my nasal cavity with a numbing agent, the physician looked at my throat using an endoscope (e.g., examining my throat using a tiny, flexible camera inserted through the nasal cavity) that didn’t seem to indicate anything out of the ordinary.  The next logical step was a CT scan to obtain additional information, which I promptly scheduled.

Discovery – Day Zero

401779-smallIt was the day before Thanksgiving and I was waiting for the water to heat up before getting into the shower.  Glancing at my reflection in the mirror, I noticed that the right side of my neck looked a bit larger than the other side.  Placing my hand on my neck, I could easily feel an unusual lump just under my jaw line that clearly wasn’t there the day before.  It was a solid mass and wasn’t sore at all to the touch.  A quick search on Google made me nervous enough to reach out to my general physician and they were kind enough to get me in that afternoon.  I’m not generally a pessimistic person, but I had already prepared myself for either lymphoma or head/neck cancer.

Remarking that he could sense the level of concern on our faces, the physician suggested that the lump was a blocked salivary gland and that such a condition could be either painful or not.  He prescribed an antibiotic (levofloxacin, 500mg) and stated that the lump should decrease after a few days unless there was a stone or other obstruction causing the blockage.  In any event, I was to follow-up with him around Monday unless there was severe pain or discomfort in which case I could consider going to the emergency room over the weekend.  In the back of my mind, I was still convinced we were dealing with something different. As stated in the peer-reviewed literature, “More than 75% of lateral neck masses in patients older than 40 years are caused by malignant tumours, and the incidence of neoplastic cervical adenopathy continues to increase with age.”¹

¹ Gleeson M, Herbert A, Richards A. Management of lateral neck masses in adults. BMJ : British Medical Journal. 2000;320(7248):1521-1524.