Cancer patient has significant reduction in tumours
by Paula Levy
published: September 24, 2003
The first time we met Rosanne Himmelman on June 18, she was just beginning a regimen of chemotherapy to fight metastic colon cancer. Through periodic updates, Rosanne is sharing her experience. This is part four of her journey.
It's good news for metastic colon cancer patient Rosanne Himmelman. Treatment has meant that tumours in her liver have been reduced by about 30 per cent.
Rosanne saw oncologist Dr. Danny Rayson on September 5 at the QEII Health Sciences Centre in Halifax to receive results of a CT (computed tomography) Scan, more commonly known as a CAT Scan.
The CT Scan is a method of examining the body using X-rays. The scan allows a picture of the tissue to be developed. The technique enables a radiologist to detect tumours and other abnormalities.
Capital Health X-ray technologist Danielle Frail explains that different substances are used to enhance specific areas of the body. Administered orally and intravenously, gastrografin and IVP dye makes the GI (gastrointestinal) track and bloodstream more visible and less penetrable by X-rays.
"When you look at X-ray ... anything that is radiolucent [allows the passage of X-rays] is black and anything that has a density to it, goes from different shades of grey to white," she says, noting the administered substances translate into more detailed pictures.
After Ms Frail has taken the pictures of Rosanne's chest, abdomen and pelvis, they are sent to the radiologist to read and compare to previous scans. The most recent scan was on June 11.
"There has been at least a 30 per cent improvement in the diameter ... which is great," says Dr. Rayson, referring to the radiologist's report.
||Rosanne positions herself so the CT Scanner can ascertain whether chemotherapy is reducing her cancerous tumours. Paula Levy photo
According to the document, one of the tumours in her liver measures 1.5 cm x 2 cm when it previously measured 4 cm x 3.8 cm. Another tumour which previously measured 4 cm x 3.8 cm, measured 2.9 cm. x 2.8 cm. Also, metastases or tumours that have spread from their site of origin appear smaller and less like they're flowing together. The lung metastases appear unchanged.
"These cancerous cells go in cycles," says Dr. Rayson. He says there is no way of knowing how many cells are still active, how many are dead, how many are sleeping. But the CT Scan gives a global impression by determining how much the tumours have shrunk.
Rosanne's current goal is to see her tumours shrink to the size they were earlier this year. The chemotherapy treatment has now confirmed that the cancer is shrinking.
"We need to keep hitting them for a certain period of time to ensure you're actually getting the most bang for what you're doing," says Dr. Rayson. "Basically putting most of those cells into remission or in fact, killing them off."
Rosanne responds that she will keep receiving treatment as long as it is helping her achieve her goals.
"I will keep at it [chemotherapy] as long as I see that the chemo is working," says Rosanne.
Coming up on her two-year anniversary of diagnosis on September 25, the size of her tumours today is a far cry from the size they were then.
"It was a huge mass. At the time it was pulsing. It was just an unbelievable thing. Now it's a lot more subtle," says Dr. Rayson, examining Rosanne.
The news of the 30 per cent reduction has surpassed Rosanne's expectations of chemotherapy. She hoped that after her first two rounds of chemo, she would have at least a 20 per cent reduction in her tumours.
"I'm hopeful because I'm seeing more regression in the first two rounds," says Rosanne.
She is comparing the results of her recent scan to the reduction she experienced after the first two rounds in 2001. She hopes that in the third and fourth rounds the decrease percentage will be even higher. In 2001, the third and fourth rounds of chemotherapy resulted in a 50 per cent reduction in the size of her tumours.
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