Newly Diagnosed with MBC: Tests, Terms, & Tips with Dr. Rebecca Shatsky
The first days, weeks, and months after being diagnosed with MBC can feel like you’ve been dropped into a dangerous and alien landscape, one whose inhabitants speak a new and confusing language. Numb and bewildered, you face a mountain of medical decisions—each of them seemingly high stakes.
If that sounds all too familiar, take a deep breath. Our goal for this third episode in our 3-part series for newly diagnosed patients is to help our listeners
1. Understand the Basics of their diagnosis
2. Make Informed Decisions about the tests their doctors order—and understand what the results mean
3. Feel Confident and Empowered to ask their doctors and other medical providers questions and to advocate for their best treatment
OMBCL senior producer Martha Carlson began by asking newly diagnosed MBC patients about what was most difficult with their medical care. The responses shaped this episode because what she heard back touched on everything from hearing the news to treatments to tests. Martha turned to leading medical oncologist Rebecca Shatsky MD from UC San Diego Health for her take on these real-life, patient-focused topics. Dr. Shatsky not only demystified doctor-speak, she gets into the details of first steps and first tests for MBC subtypes, the differences between CTs and PET scans, what blood biopsies and tissue biopsies tell our oncologists and so much more. Because few things connect us better than sharing our stories, Martha also asked experienced MBC patients a single question: What do you wish you knew when you were first diagnosed? Throughout the episode, we hear from experienced patient advocates Dr. Kelly Shanahan, Sheila Johnson, Joan Mancuso, Marissa Holzer, and Ashley Fernandez.
Definitions
MRI: Magnetic Resonance Imaging is a non-invasive imaging technology that produces three dimensional detailed anatomical images. It is often used for disease detection, diagnosis, and treatment monitoring.
CT: Computerized Tomography scan combines a series of X-ray images taken from different angles around your body and uses computer processing to create cross-sectional images (slices) of the bones, blood vessels and soft tissues inside your body. CT scan images provide more-detailed information than plain X-rays.
PET: Positron Emission Tomography scan is an imaging test that can help reveal the metabolic or biochemical function of your tissues and organs. The PET scan uses a radioactive drug called a tracer to show both typical and atypical metabolic activity. A PET scan can often detect the atypical metabolism of the tracer in diseases before the disease shows up on other imaging tests, such as computerized tomography (CT) and magnetic resonance imaging (MRI).
PET-CT: The combination of CT and PET imaging reveals information about both the structure (from the CT scan) and the function (from the PET scan) of cells and tissues in the body during a single session.
Bone Scan: A procedure, also called bone scintigraphy, to check for abnormal areas or damage in the bones. A very small amount of radioactive material is injected into a vein and travels through the blood. The radioactive material collects in the bones and is detected by a scanner.
ctDNA: Tumors are made up of cells, and at the center of those cells is DNA. As cancer cells go through their life cycle, fragments of DNA can enter the bloodstream. This is known as circulating tumor DNA – or ctDNA, for short. ctDNA testing examines a patient's blood to detect DNA fragments from cancer cells.
Extravasation: The process by which any liquid (fluid or drug) accidentally leaks into the surrounding tissue. In terms of cancer therapy, extravasation refers to the inadvertent infiltration of chemotherapy into the subcutaneous or subdermal tissues surrounding the intravenous or intra-arterial administration site.
Liquid (also known as blood) Biopsy: A blood test that detects cancer cells or DNA that are circulating in the blood, called “circulating tumor DNA” or “ctDNA.” Like healthy cells, cancer cells die and are replaced. When these dead cells break down, they are released from the tumor into the bloodstream.
Links to Additional Information & Genetic Testing
You can listen to our previous episode on FES/PET Cerianna Screening for Estrogen Positive MBC patients for more information on this type of scan.
This article on blood clots/thrombosis by Diane Mapes provides additional information.