Metabolic Resolution

I am backtracking to last Monday. I did the mid-treatment scan and the results indicate that all the hotspot, except one, show metabolic resolution. Yes indeed, what does that really mean? The medical jargons de-personalise it by leading you into thinking that it is about "the subject" and not you. I caught myself looking at the name of the report a couple of times as if to confirm that it is really my report. Or perhaps I sub-consciously did that because it was the only part of the report I could comprehend.

What I went for was a F-18 Flourodeoxyglucose (FDG) Positron Emission Tomographic (PET) scan coupled with non-contrast Computed Tomography (CT) scan. Essentially I took radioactive sugar as a tracer. The level of tracer uptake by the cells in the body are markers for cancer. Malignant cells metabolise glucose at a much faster rate than healthy cells. The results are correlated with the 3D  x-rays from the CT scan to give the doctor a pretty good idea of what is happening inside down to the cellular level.

Metabolic resolution means that the metabolic process in the areas that were previously hotspots is back to normal, hence a resolution. I wouldn't blame you for thinking that it meant the PET scan resolution has picked up some unusual activities there. Always useful to have the oncologist guide you through the report. So very positive news. The treatment is working as intended. "The previously noted FDG-avid lymph node in the para-oesophageal region has reduced in metabolic activity and size". That is the remaining malignant cells that still need to be cleared out over the course of the next 3 months. The oncologist said that overall the results are within expectations and nothing out of the ordinary.

Someone asked me whether I was happy with the result? I took a moment to figure out a response. I wasn't happy as in I was jumping out and down. I wasn't particularly stressed up about what the scan may say because I have in some ways learnt to take it as it comes. Nevertheless relieved, even though there is remnant that needs to clear up. Thankful is perhaps a better description.

I am thankful for so much support, encouragement and prayers over the last few months. And I am thankful that God speaks loudly and clearly in uncertain times.


As the rain and the snow
    come down from heaven,
and do not return to it
    without watering the earth
and making it bud and flourish,
    so that it yields seed for the sower and bread for the eater,
11 so is my word that goes out from my mouth:
    It will not return to me empty,
but will accomplish what I desire
    and achieve the purpose for which I sent it.
12 You will go out in joy
    and be led forth in peace;
the mountains and hills
    will burst into song before you,
and all the trees of the field
    will clap their hands.
13 Instead of the thornbush will grow the juniper,
    and instead of briers the myrtle will grow.
This will be for the Lord’s renown,
    for an everlasting sign,
    that will endure forever.”
~ Isaiah 55: 10-13