My mom picked me up and we had lab work done and then met with Helena. The head ct showed I had cancer in the frontal lobe of my brain. The spot is small about 5mm in size. They believe it can be managed quite successfully with a radiation procedure called Cyberknife. I called John and he left work and came to the center to meet the doctor at 12:30 today. We will use next week preparing for the procedure and it will be completed the week of the 17th: Tues or Thurs. Once again we find ourselves with a gift from God. After the radiation oncologist reviewed all the results. He did not believe the symptoms I was experiencing were related to the brain tumor the size of the tumor was too small. He looked over my labs and noted my ammonia level and liver function tests  were all elevated. This could produce all the sign & symptoms I am currently having.

Sweet’s syndrome is a skin disorder characterized by fever and painful skin lesions. The condition starts suddenly with the appearance of red, slightly raised and tender bumps (plaques), usually on your back, arms, face or neck. These painful bumps rapidly increase in size, and they may progress to blisters. In most cases, the cause of Sweet’s syndrome is undetermined. However, Sweet’s syndrome may follow an upper respiratory infection in young adults. Rarely, Sweet’s syndrome may occur as a reaction to medication. In older adults, Sweet’s syndrome can be associated with certain types of cancer, such as leukemia. Sweet’s syndrome occurs most often in women 30 to 50 years of age. Treatment of Sweet’s syndrome, also known as acute febrile neutrophilic dermatosis, is with oral and/or topical medications.

Signs and symptoms
The distinctive skin lesions are the most obvious sign of Sweet’s syndrome. The lesions seem to appear suddenly as a series of small red bumps that quickly increase in size. The bumps, also called plaques, may grow to be 1 centimeter in diameter or larger. Plaques usually appear on your back, neck, arms and face. These tender and painful eruptions may develop blisters, pustules or ulcers, causing your skin to burn or itch. The skin lesions may persist for weeks to months and then disappear on their own, even without medication. With medical treatment, you’re likely to be free of skin lesions within just a few days.

Sweet’s syndrome may be your body’s reaction to an internal problem, so it’s possible for you to develop the skin lesions at the same time you’re experiencing problems with your bones, nervous system, kidneys, intestines, liver, heart, lungs, muscles or spleen. Some of the other specific signs and symptoms of Sweet’s syndrome may include:

• Moderate to high fever
• Pink eye (conjunctivitis) or sore eyes
• Tiredness
• Aching joints and headache
• Mouth ulcers

Causes
The cause of Sweet’s syndrome is usually impossible to determine (idiopathic). But in some cases, it may be your body’s immune system reacting to one of the following conditions or circumstances:

• An upper respiratory tract infection, such as a chest infection or strep throat
• Blood disorders, including leukemia in older adults (especially acute myelogenous leukemia, a cancer of the blood and bone marrow)
• Inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease
• Bowel or breast cancer
• Pregnancy
• Rheumatoid arthritis
• An injury at the site where the rash appears, such as from an insect bite or needle prick
• Certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), Neupogen

Risk factors
Women are most at risk of Sweet’s syndrome, predominately women between the ages of 30 and 50 who have recently had an upper respiratory tract infection. The condition has also been reported in children as young as 3 months and in adults as old as 85. Pregnant women may get Sweet’s syndrome during their first or second trimester. In these cases, the condition usually goes away without medication.Sweet’s syndrome tends to recur. About one-third of people who have had Sweet’s syndrome get it again.

Screening and diagnosis
Your doctor can make a diagnosis of Sweet’s syndrome by:

• The distinctive rash. These red, tender and painful bumps rapidly increase in size and may progress to blisters.
• Blood tests. Your doctor may take a small sample of blood and have it analyzed to see if you have an unusually high number of white blood cells, which is characteristic of Sweet’s syndrome. Your body produces additional white blood cells to defend against inflammation or an infection.
• Tissue sample. Your doctor may remove a small piece of affected tissue (biopsy) for examination under a microscope. The tissue is analyzed to determine whether it has the characteristic abnormalities of Sweet’s syndrome.

Complications
Sweet’s syndrome may be a warning sign that your body has a more serious internal problem. For this reason seeking medical care is critical.

For example, Sweet’s syndrome sometimes develops as your body’s reaction very early in the course of cancer, possibly at a curable stage. Sweet’s syndrome may also develop at the same time as other internal problems in your bones, nervous system, kidneys, intestines, liver, heart, lungs, muscles or spleen. Some specific examples of these conditions may include:

• Inflammatory bowel disease
• Infections of the upper respiratory tract, including strep throat, pneumonia and tonsillitis
• Urinary tract infections
• Infections of the liver and gastrointestinal tract
• Certain systemic infections

Treatment
Left untreated, Sweet’s syndrome not associated with a malignancy may disappear on its own within one to three months. In contrast, the right treatment may improve the skin lesions and associated symptoms dramatically in just two or three days, with the worst of the lesions disappearing within one to four weeks. With or without treatment, the plaques and lesions rarely leave a mark or scar when they eventually disappear. Your doctor may advise continuing treatment because recurrence of the condition is common.

Medications
Doctors typically prescribe systemic corticosteroids (prednisone or prednisolone) to treat Sweet’s syndrome. These oral anti-inflammatory medications lessen redness, itching, swelling and allergic reactions. But there are potential side effects. Corticosteroids may lower your resistance to infections. Also, any infection you get while taking corticosteroids may be harder to treat. Corticosteroids may also cause blurred vision, frequent urination and increased thirst. Your doctor may also recommend topical corticosteroid treatments to provide direct relief of redness, swelling, itching and discomfort of skin  lesions. In addition, your doctor may suggest that you take nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen or naproxen sodium to reduce inflammation and relieve other signs and symptoms, such as fever and headache.

Reference: http://www.mayoclinic.com/print/sweets-syndrome/DS00752/DSECTION=all&METHOD=print

A WBC scan is a nuclear scan in which a radioactive material is attached to a sample of white blood cells. It is done to locate areas of infection or inflammation that are hidden from traditional tests. Blood is taken from one of your veins. White blood cells are separated from the rest of the blood sample and then mixed with a small amount of a radioactive material (radioisotope) called indium-111. The cells with the radioactive material are considered “tagged.” About 2 or 3 hours later, the tagged white blood cells are returned to your body through injection into a vein. The tagged cells gather in areas of inflammation or infection.

Approximately 24 hours later, your body is scanned. You lie on a table. The scanner looks like an x-ray machine. It detects the radiation given off by the radioactive white blood cells. A computer converts the detected radiation into an image that can be viewed on a screen or recorded on film. The scan takes about 1 or 2 hours. The scanner is usually located in a hospital, but often the test can be performed on an outpatient basis. After the test is completed, no recovery time or special precautions are necessary.

A normal result means there are no accumulations of tagged cells (except for a certain amount in the liver and spleen, which normally accumulate white blood cells). Abnormal results usually suggest an active inflammation or infection, such as a liver abscess or abdominal abscess.

Tumor Markers: What do they mean? 

Tumor markers are measurable biochemicals that are associated with a malignancy. They are either produced by tumor cells (tumor-derived) or by the body in response to tumor cells (tumor-associated). They are typically substances that are released into the circulation and thus measured in the blood. Once cancer is diagnosed, tumor marker levels sometimes help to determine the extent of cancer. Higher levels can indicate more advanced cancer and a worse prognosis in some cases. The patient and their physician may use this information to choose between more or less aggressive treatments.

Monitoring cancer treatment is the most common use of tumor markers. As cancer is reduced, levels often decrease. Stable or increasing levels often indicate that the cancer is not responding to treatment. The choice of tumor marker to use for monitoring is important. Only a marker elevated before treatment should be used to monitor a person during or after treatment. Timing of the tests is also important. Each tumor marker has a unique life span in the blood. To monitor a treatment’s success, enough time must have passed for the initial marker to be cleared from the blood. Tests done too soon may be falsely elevated because the marker produced by the untreated cancer is still present.

Watching for cancer recurrence after treatment is another reason for tumor marker testing. Periodic testing can sometimes detect a recurrence often months earlier than could an ultrasound, x ray, or physical examination. Conclusions based on tumor marker tests are seldom based on one test result but on a series of test results, called serial measurements. A series of increasing or decreasing values is more significant than a single value.

Tumor marker testing is currently the object of much research and attention. Their use is directed by approval from the Food and Drug Administration (FDA) and guidelines established by organizations such as the American Society of Clinical Oncology and the American Cancer Society. Not all tumor receptor marker tests are widely available nor are they widely accepted

CA 15-3 is produced by cells in the breast and increased levels can be associated with breast cancer. Rarely increased in women with early breast cancer, it may be used to detect recurrence of cancer in women following treatment or mastectomy and to monitor treatment for women with advanced breast cancer. However, adenocarcinomas of the ovary, lung, colon, and pancreas also express elevated CA 15-3 levels. Non-cancerous conditions sometimes associated with elevated CA 15-3 include benign breast or ovarian disease, endometriosis, pelvic inflammatory disease, and hepatitis. Pregnancy and lactation are also related to high CA 15-3 levels.

CA 27-29, also called breast carcinoma-associated antigen, is used as a marker for breast cancer. Eighty percent of women with breast cancer have an increased CA 27-29 level. This marker may be used with other procedures and tumor marker levels such as CA 15-3 to check for recurrences of cancer in previously treated women. Serial measurements monitor treatment response and identify recurrence. Levels of CA 27-29 may also be increased in cancers of the colon, stomach, kidney, lung, ovary, pancreas, uterus, and liver. Noncancerous conditions associated with elevated CA 27-29 include first trimester pregnancy, endometriosis, ovarian cysts, non-cancerous breast disease, kidney disease, and liver disease.

I hope you have find the lesson in tumor markers informative. As we have learned they are just a piece of the puzzle and a guide. They not an absolute. All these advances are here today as a result of research and a combination of monies and time invested to find a cure for Breast Cancer. Raising money and creating an increased awareness has become a mission for us. We appreciate the financial support for the Komen 3-Day. We look forward to the day we can share the national Komen commercial with you. One day we will have a cure.

The real number of white blood cells (WBCs) is called absolute neutrophil count (ANC). The ANC is not measured directly. It is derived by multiplying the WBC count times the percent of neutrophils in the differential WBC count. The percent of neutrophils consists of the segmented (fully mature) neutrophils) + the bands (almost mature neutrophils). The normal range for the ANC = 1.5 to 8.0 (1,500 to 8,000/mm3). Per the protocol the cutoff for “no chemo” is < 1000. My ANC today is just high enough at 1200.

ZOMETA (zoledronic acid) Injection is an infused therapy and a member of the class of medicines called bisphosphonates. ZOMETA works by slowing the bone destroying activity that occurs with bone metastases. It also works by fighting the abnormal cells that cause bone to wear away (osteolytic lesion). Bone metastases wear away portions of bone leaving small holes called osteolytic bone lesions. This wearing away process causes eroded bone to appear as circular punched out areas. It leaves bones weak and fragile. Slowing the abnormal buildup of unstable bone (osteoblastic lesion) Bone metastases can also cause abnormal bone formation. Areas of new bone form but they are weak and unstable and can break easily or collapse. These areas are called osteoblastic bone lesions.

ZOMETA reduces the risk of bone complications such as bone fracture hypercalcemia of malignancy and spinal cord compression. ZOMETA helps restore the normal process of bone remodeling thus reducing the chance of bone complications. Even patients who have already had complications such as bone fracture radiation or bone surgery can be helped by treatment with ZOMETA.

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I heard from the team at The Center today. My lab work continues to trend up which is the wrong direction. They are going to schedule me for a PET scan. Someone should call tomorrow with a date and time. A positron emission tomography (PET) scan is a unique type of imaging test that helps the team see how the organs and tissues inside my body are actually functioning. PET scans are most commonly used to detect cancer, heart problems, brain disorders and other central nervous system disorders.

A PET scan can measure vital functions such as blood flow, oxygen use, and glucose metabolism, which helps doctors identify abnormal from normal functioning organs and tissues. One of the main differences between PET scans and other imaging tests like CT scan or MRI is that the PET scan reveals the cellular level metabolic changes occurring in an organ or tissue. This is important and unique because disease processes often begin with functional changes at the cellular level. A PET scan can often detect these very early changes whereas a CT or MRI detect changes a little later as the disease begins to cause changes in the structure of organs or tissues. The scan can also be used to evaluate the effectiveness of my treatment plan, allowing the course of care to be adjusted if necessary.

So my mighty warriors let us pray:
Dear Lord,
We ask you to guide and direct the medical team helping them find clear direction and the identification of a treatment plan that will be successful in battling this disease. We pray for comfort and a sense of peace for all that are worried and fearful about this battle. We know through you all things are possible. We thank you for the many gifts you have given us.

Amen

Grace & Peace,

Stephanie