Chapter 4: Stage 3 MCL

With the initial diagnostic tests behind me, the focus shifted to unraveling the stage at which my cancer stood.

The bone marrow biopsy yielded a reassuring outcome – no detectable cancer in the bone marrow. Simultaneously, the PET scan showcased a lack of active cancer in major organs, yet pinpointed areas of concern, particularly in the pelvic region.

In the pelvic area, specific lymph nodes displayed a Standardized Uptake Value (SUV) of 5.5. Generally, an SUV exceeding 2.0-2.5 raises suspicions of malignancy. While SUV isn’t flawless, its reliability was notable. This initial PET scan not only identified active cancer regions but also established a baseline for subsequent comparative scans.

Further complexity emerged with the Ki-67 proliferation index, indicating a substantial 40%. Greater than 20% is considered very active. The challenge here lies in the universal agreement of what Ki-67 represents in each patient.

Adding another layer of assessment, the Deauville score, registering at 5 on a scale of 1 to 5, provided an internationally recommended metric for initial staging and treatment evaluation. Despite active tumors in multiple body regions, the staging settled at 3, given the absence of detectable cancer in major organs or the bone marrow.

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