Plan is on track.

[Guest guest]

I did a PET-CT to track the effectiveness of the immune meds and

differentiation meds that I cooked up for myself. The idea was to

heal the very large metastatic cancer without causing ulceration, so

I would be able to avoid any surgery. The sacral mets were present

before I started my program. A month ago I was limping and that is

completely gone. Everything seems to be going according to

plan. The lung metastasis is actually a plus. This takes any

surgery with a bogus " curative intent " off the table. The low SUV

takes chemo off the table. I'm probably easily in the top 1% of all

patients with this stage 4 cancer and with my supposed terminal prognosis.

My health has completely returned and the Center retreat program is full time.

PATIENT: GAMMILL, VINCENT

DATE: 07/30/10

EXAM: PET/CT IMAGING

HISTORY:

This is a 64-year-old with residual anal tumor. Also, note progress

of small right apical lung nodule.

PROCEDURE:

The patient received fluorine-18 FDG 13 mCi intravenously in the

right antecubital fossa. Glucose level at the time of injection was

107. Approximately one hour later, tomographic imaging was obtained

from the base of the brain to the upper thighs. A concurrent low

energy unenhanced CT scan was performed for the purposes of fusion

and attenuation correction.

REFERENCE STUDY:

PET/CT scan from 12/28/09 and CT scan of the chest from 12/24/09.

FINDINGS:

There has been considerable improvement in the intense uptake

previously located in the large anal mass. There is only some faint

residual activity to the left of midline associated with some soft

tissue thickening. This may represent resolving inflammation. The

standardized uptake value measures 4. The finding is nonspecific and

the possibility of some residual neoplasm cannot be completely

excluded. There is new increased uptake involving the right sacral

ala. This new diffuse area of uptake is very mild. The standardized

uptake value measured 3.6. However, there is concerning new mild

sclerosis in this area without evidence of a fracture line. The

overall finding is worrisome for metastatic disease.

There is no change in the 5-6 mm right upper lobe lung nodule since

the prior studies. There is no associated uptake on the PET scan.

IMPRESSION:

1. Significant improvement in the appearance of the rectal mass

with only some residual thickening associated with some minimal

increased activity to the left of midline. This probably represents

ongoing healing. The small possibility of residual disease cannot be

completely excluded.

2. New uptake associated with new sclerosis involving the right

sacral ala is suspicious for new metastatic disease.

3. No change in the right upper lobe lung nodule. This has no

uptake on PET scan however it is below the size typically detected by

PET imaging.