I started immunotherapy infusions for stage 4 metastatic melanoma in June 2022 and had been waiting in hope and fear for the middle of the course of treatment when I would have a PET scan. The PET shows metabolic activity and can help reveal cancer. In fact, the PET scan I had in February 2022 confirmed the suspected adrenal tumor and a bonus active lung nodule that we hadn’t known about until then. I ended up having both tumors removed in separate surgeries in April and May.
My oncologist ordered this latest PET in early November. This was always the plan. Six infusions in and I was eager for news.
Unfortunately, my insurance denied coverage. As is their brutal custom, I learned this through a recorded message from the third party that makes the decision.
I quickly cycled through rage and fear and despair and then worked with my oncologist to instead score a CT scan of my abdomen and pelvis.
The week following the test, after obsessively checking the patient portal, I discovered the test results: 2 small nodules in my right lung. Specifically:
Small 3 to 4 mm subpleural posterior right lower lobe nodule on image 33 of series 5-nonspecific but better visualized than prior studies-attention at follow-up suggested.
Otherwise, Stable appearance of the CT chest, abdomen and pelvis compared to the prior examination. A 4 mm right upper lobe pulmonary nodule abutting the fissure is very similar. Postoperative changes again noted.
Unlike a PET, the CT doesn’t show activity, so I didn’t know if I should start worrying. I didn’t hear from the oncologist and messaged them after sitting on this info for a few days. The doctor through the nurse told me to chill out. Specifically:
Dr X was happy with the CT scan results, he doesn’t think the two small nodules warrant any further action at this time. He currently plans to rescan you in about 3 months to keep a close eye on everything.
I’m quite sure I wanted that PET as a guarantee that everything would be okay. Even though I know I can’t have a guarantee. Not having a guarantee is naturally unsettling but not so different than anything else that I and all of us face. I started to think about how I felt: nothing is different in this moment. Maybe I could follow my doctor’s joyful lead and be happy today.