Bone Cancer: Part 2: May 19: PET/CT Scan

Bone Cancer: Part 1

The following was written on May 13, and is the first segment of an ongoing narrative. Please forgive me for leaving you in the lurch; I will get you caught up as soon as I can.

In February, Peggy began to complain of pain shooting down her upper right thigh. On March 5, she went to her internist of 35-years, Kirk Jacobson for diagnosis and treatment. Kirk thought the pain was coming from her hip and ordered a hip x-ray. When nothing was found, he ordered a lumbar spine x-ray. When Peggy saw Kirk again on April 11, he ordered an MRI of her lumbar spine. When bulging discs and stenosis were found, he sent her to a pain specialist named Adam Kemp for a possible nerve block. Peggy saw Kemp on April 24, and was told that the pain might be caused by an inflamed tendon in her right hip, so he ordered an MRI. She had the MRI done six days later, but couldn't see Kemp's schedule for a follow-up appointment until June. 

Because her pain was worsening daily, she called Kemp's office on May 7, and said that she couldn't wait until June to see him. She also asked for a copy of her MRI results but was inexplicably refused. Due to a cancellation, she was able to see Kemp the next day (May 8). While she and I were waiting for him to enter the exam room, a woman walked in, handed Peggy a piece of paper, and walked out. Peggy saw that the paper contained her MRI results, which alluded to "the possibility of metastatic bone lesions to the iliac bone." Kemp hadn't looked at the results prior to entering the room, and, upon seeing them, blamed Oregon Imaging for not alerting him to their seriousness. 

He then ordered three additional imaging tests, but when Peggy called later that day to make an appointment she was told that one of his orders needed clarification. An order that didn't need clarification called for a CT scan of the right hip, and Peggy had one done on May 10, two days after seeing Kemp. This time, she asked Oregon Imaging to send her the results directly. On May 12, they emailed her a report which contained the terror-instilling words: "This most likely represents osseous metastatic disease". 

Eight days later, Oregon Imaging still didn't know what Kemp wanted done despite Peggy, Oregon Imaging, and me making repeated and impassionedd (at least on my part), efforts to find out. She called Kemp's office a final time on May 14, to say she was done seeing him so there was no need for him to clarify his orders. His office called the next day to say that his orders had been clarified. During the week that we wasted calling Kemp, Peggy called Kirk (her internist), and explained the situation. Kirk immediately ordered a PET-CT scan, which is to be done on Monday, May 19.
 
Bone cancer that originates in the bone constitutes only 1% of all cancers. Secondary bone cancer is terminal and can originate in many places. In women, it most commonly migrates from the breasts or lungs. If she has boner cancer and if it came from her breasts (she has yearly mammograms), her odds of being alive in five years is 13%. If the cancer spread from her lungs (she has had lung problems since getting Valley Fever in Fresno, California, in 1986), the likelihood is that she will be dead this time next year.