This I do not understand. I found an article on the how this new test speeds up the testing of the sentinel lymph node in breast cancer surgery in the UK. Previously it took 15 working days (!!!!) to get the test results. That's three weeks. That's completely crazy.
When I had my (bad) lumpectomy here in the US, I was told the instant test during surgery of the sentinel node had a margin of error of 50% and it really wasn't worth doing. The sentinel node was checked by the lab after surgery to confirm the results. I know several women who were told that the test they had during surgery was wrong so I guess my surgeon was right on this.
Now that was six years ago so technology must have changed and now there is a new test available in the UK for instant testing of the sentinel node during surgery. I hope the margin of error is less now.
But I digress. I just do not understand why it takes a lab in the UK 15 working days to confirm the presence of cancer. Three weeks? In my non medical understanding it is a relatively quick test - not like the ones which need to grow cells or something.
I remember being promised my results within a week and getting them in about four days. So why does it take three weeks on the other side of the ocean?
Showing posts with label test results. Show all posts
Showing posts with label test results. Show all posts
Basic screening tests take on a new meaning after cancer
Most people, by this I mean people who have never had cancer, go to the doctor for check ups and get sent for tests and don't think twice. They get nice negative results sent to them in the mail and they don't think twice about it.
Throw in a few cancer diagnoses, and any screening test takes an ominous turn. Of course any screening test will show that you are doomed. There is no way you will ever get a clean result again. One test will lead to another which will lead to another which will lead to another and then surgery, chemo, and more and more and more.
Or so the little voices in your head tell you.
It is perfectly acceptable to have little voices in your head after cancer.
Its when they take over all rational thought that you really are screwed. This is why we have psychiatrists, psychologists, and anti-depressants to keep us sane.
However our screening tests still can drive us crazy.
Throw in a few cancer diagnoses, and any screening test takes an ominous turn. Of course any screening test will show that you are doomed. There is no way you will ever get a clean result again. One test will lead to another which will lead to another which will lead to another and then surgery, chemo, and more and more and more.
Or so the little voices in your head tell you.
It is perfectly acceptable to have little voices in your head after cancer.
Its when they take over all rational thought that you really are screwed. This is why we have psychiatrists, psychologists, and anti-depressants to keep us sane.
However our screening tests still can drive us crazy.
That was stupid (on my part)
They (the all knowing all powerful they) insist that patients should get and keep all of their medical test results. They say its the smart thing to do. So being smart, yesterday I went off to get a copy of my CT scan results so I can read it myself and obey 'them'.
Now I'm sorry I did.
I know the value of having a doctor interpret the results but the ER doctor had already told me no injuries, just some arthritis in my neck.
I also know that some things show up on test results that the radiologists comment on but aren't really important and can be ignored.
But now I want to call my doctor to find out if I should be concerned. Both tests, the head CT and the neck CT, conclude with no acute findings with chronic findings as noted. Acute means no injuries. Chronic means never going to go away.
I had a spine MRI about four years ago and will attempt to dig out the results which are buried in my folder of medical test results later today. I do not believe that MRI reported any chronic findings with my neck or cervical spine.
My concern is where the CT test results say things like:
"There is mild prominence of extra-axial volume loss" when they talk about my brain. Is my brain shrinking?
"There is minimal degenerative anterolisthesis at C3/4 and minimal degenerative retrolisthesis at C4/C5. A C4/C5 there is minimal narrowing of the central canal due to broad-based disc osteophyte. There is moderate narrowing of the bony right neural foramen due to disc and uncovertebral joint degeneration."
My concerns are:
As far as the ER doctor was concerned, I was not injured in the accident but I don't think he cares about the other stuff. Nothing against him as its not part of his job.
I will call my PCP and see if I can talk to her about this and find out if I should be concerned or if I should make an appointment. I was stupid. I should have ignored the report until my next appointment.
Now I'm sorry I did.
I know the value of having a doctor interpret the results but the ER doctor had already told me no injuries, just some arthritis in my neck.
I also know that some things show up on test results that the radiologists comment on but aren't really important and can be ignored.
But now I want to call my doctor to find out if I should be concerned. Both tests, the head CT and the neck CT, conclude with no acute findings with chronic findings as noted. Acute means no injuries. Chronic means never going to go away.
I had a spine MRI about four years ago and will attempt to dig out the results which are buried in my folder of medical test results later today. I do not believe that MRI reported any chronic findings with my neck or cervical spine.
My concern is where the CT test results say things like:
"There is mild prominence of extra-axial volume loss" when they talk about my brain. Is my brain shrinking?
"There is minimal degenerative anterolisthesis at C3/4 and minimal degenerative retrolisthesis at C4/C5. A C4/C5 there is minimal narrowing of the central canal due to broad-based disc osteophyte. There is moderate narrowing of the bony right neural foramen due to disc and uncovertebral joint degeneration."
My concerns are:
- If these are chronic are they going to get worse or stay the same?
- Why did they happen?
- Should I be concerned? Which I guess is my main question.
As far as the ER doctor was concerned, I was not injured in the accident but I don't think he cares about the other stuff. Nothing against him as its not part of his job.
I will call my PCP and see if I can talk to her about this and find out if I should be concerned or if I should make an appointment. I was stupid. I should have ignored the report until my next appointment.
More cliff news
Finally I caught up with my oncologist yesterday. She could still barely talk after being out with the flu but I had called after I waited nearly a week. I saw her nurse practitioner on Monday and called after lunch on Friday. I thought that was long enough to leave me dangling on the Femara cliff.
Last August when I saw her, she was all set to take me off Femara at this visit. We talked about it so I could emotionally prepare for the cliff of the end of breast cancer treatment. I did stress over it, think about it, whine about it, and otherwise cope maturely.
When I went to my appointment on Monday she was out with the stomach flu so I saw one of her nurse practitioners who indicated there is new research so maybe I wouldn't be going off Femara right away (despite my stress, whining, and thinking). And that is the case.
There is new research in the past month or two that says that more might be better in terms of breast cancer treatment. It has been thought that ten years of Tamoxifen might be better than five for premenopausal women. Now it is thought that up to ten years of Femara might be better for postmenopausal women. And for people like me who had over two years of Tamoxifen and switched, originally aiming for a total of five years of hormonal treatment, it is thought that five years of Femara plus the two plus years of Tamoxifen is better.
So now here is the new plan. I will continue on Femara for up to two and one-half more years based on how my bones/osteoporosis are doing for a total of five years on it if possible. We will assess after each annual bone density test in May. I can also be treated for osteoporosis while on Femara so that is an option as well.
I am a high risk for osteoporosis due to a strong family history, synthetic thyroid hormone is also hard on your bones, and Femara is really hard on your bones. Combined with all that, I had osteopenia (precursor to osteoporosis) before I started all this breast cancer crap (and crap it is).
This has been the story of my cancer treatment - I am always the 'different' case - because of your medical history we need to be sure. Triple grr.
Damn the new research and the stupid moving cliff.
Last August when I saw her, she was all set to take me off Femara at this visit. We talked about it so I could emotionally prepare for the cliff of the end of breast cancer treatment. I did stress over it, think about it, whine about it, and otherwise cope maturely.
When I went to my appointment on Monday she was out with the stomach flu so I saw one of her nurse practitioners who indicated there is new research so maybe I wouldn't be going off Femara right away (despite my stress, whining, and thinking). And that is the case.
There is new research in the past month or two that says that more might be better in terms of breast cancer treatment. It has been thought that ten years of Tamoxifen might be better than five for premenopausal women. Now it is thought that up to ten years of Femara might be better for postmenopausal women. And for people like me who had over two years of Tamoxifen and switched, originally aiming for a total of five years of hormonal treatment, it is thought that five years of Femara plus the two plus years of Tamoxifen is better.
So now here is the new plan. I will continue on Femara for up to two and one-half more years based on how my bones/osteoporosis are doing for a total of five years on it if possible. We will assess after each annual bone density test in May. I can also be treated for osteoporosis while on Femara so that is an option as well.
I am a high risk for osteoporosis due to a strong family history, synthetic thyroid hormone is also hard on your bones, and Femara is really hard on your bones. Combined with all that, I had osteopenia (precursor to osteoporosis) before I started all this breast cancer crap (and crap it is).
This has been the story of my cancer treatment - I am always the 'different' case - because of your medical history we need to be sure. Triple grr.
Damn the new research and the stupid moving cliff.
A picture paints 1000 words
We all hear 'we need to wait for the pathology report' and 'Tamoxifen prevents breast cancer recurrence'. But what exactly does this look like? I had no idea. Now I do, thanks to Cure Magazine (www.curetoday.com) - go get a subscription if you have or had cancer and don't receive it.
On the left we have: Estrogen binds to the estrogen receptor, initiating a cascade of events that activate certain genes leading to tumor cell growth.
On the right we have:Tamoxifen blocks estrogen binding to the estrogen receptor, stopping tumor growth.
Starting from the left:
Immunohistochemitry (IHC) for the estrogen receptor in the cell nucleus. Left to right: Low, mildly positive, and highly positive.
Next image: Flourescence in situ hybridization (FISH) tests for Her2 expression by staining a control chromosome green and the Her2 receptor pink.
Final image: Immunohistochemistry (IHC) tests show the Her2 receptor at the cell surface.
On the left we have: Estrogen binds to the estrogen receptor, initiating a cascade of events that activate certain genes leading to tumor cell growth.
On the right we have:Tamoxifen blocks estrogen binding to the estrogen receptor, stopping tumor growth.
Immunohistochemitry (IHC) for the estrogen receptor in the cell nucleus. Left to right: Low, mildly positive, and highly positive.
Next image: Flourescence in situ hybridization (FISH) tests for Her2 expression by staining a control chromosome green and the Her2 receptor pink.
Final image: Immunohistochemistry (IHC) tests show the Her2 receptor at the cell surface.
Dealing with test results
We all have medical tests and adventures that provide little insights into our health. Gone are the days where we are at the doctor's mercy for our results. But now with changes in legislation, both current and future, patients will be able to directly access their results.
This is good and bad. Yes there is a bad side to it. Go read this article on it and the one below it. I am all for patients getting their test results promptly. But the problem is understanding and coping with them.
Its fine to get results promptly when they are what is expected. Normal blood counts, benign biopsies, and the like. But what about when they are vague or are not as expected? And how to decipher the doctor shorthand?
This is the balance that we need to decode. When I use the word 'we' I am referring to both the patients and the medical profession. The doctor can not be expected to be able to access and review all test results and get back to the patients promptly. They would end up being buried in paperwork.
However a system needs to be developed where speed of response is included and deciphering of results made available. Part of this is the patient's responsibility. Before a test, ask the doctor and the technician when and how the results will be made available. Make sure you understand what they are trying to find out and what the options are for good and bad results.
If its your standard annual blood tests, maybe you are comfortable with not asking many questions. Or you get sent for a blood test for a possible new condition - what does a negative result mean vs. a positive result? If you have the ailment what is next? If you don't have the ailment, well great they ruled that out so what is next?
As a cancer patient, you get all sorts of wonderful medical adventures with complicated results. We need to know what they mean but we are not waiting for our results. Our cancer diagnoses gives us a special pass for speedy results. But we still need to have our little plan of action for each one. \
Speed here is essential but channels of communication need to be there so that the information can be digested and processed.
This is good and bad. Yes there is a bad side to it. Go read this article on it and the one below it. I am all for patients getting their test results promptly. But the problem is understanding and coping with them.
Its fine to get results promptly when they are what is expected. Normal blood counts, benign biopsies, and the like. But what about when they are vague or are not as expected? And how to decipher the doctor shorthand?
This is the balance that we need to decode. When I use the word 'we' I am referring to both the patients and the medical profession. The doctor can not be expected to be able to access and review all test results and get back to the patients promptly. They would end up being buried in paperwork.
However a system needs to be developed where speed of response is included and deciphering of results made available. Part of this is the patient's responsibility. Before a test, ask the doctor and the technician when and how the results will be made available. Make sure you understand what they are trying to find out and what the options are for good and bad results.
If its your standard annual blood tests, maybe you are comfortable with not asking many questions. Or you get sent for a blood test for a possible new condition - what does a negative result mean vs. a positive result? If you have the ailment what is next? If you don't have the ailment, well great they ruled that out so what is next?
As a cancer patient, you get all sorts of wonderful medical adventures with complicated results. We need to know what they mean but we are not waiting for our results. Our cancer diagnoses gives us a special pass for speedy results. But we still need to have our little plan of action for each one. \
Speed here is essential but channels of communication need to be there so that the information can be digested and processed.
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