Reading Between the Lines: Scan + Biopsy = One Complicated Story

May 14, 2025

Every scan tells a story, but this time, it’s not the whole story.

Alongside my latest imaging, we also got new biopsy results. And together, they paint a picture that’s more layered. Not simple. Not final. But important.

Let’s start with the scan.

The main tumor in my abdomen has gotten a little smaller. That part is encouraging. But it’s also more active, which sounds counterintuitive.

Here’s what that means: PET scans use a type of radioactive sugar to highlight metabolic activity in the body. Cancer cells tend to consume more sugar than normal cells because they grow and divide rapidly, they’re constantly hungry for energy. So when a tumor lights up more brightly on the scan, it usually means it’s pulling in more glucose. Think of it like a fire that’s been trimmed back around the edges, but is now burning hotter at its core.

Some of the lymph nodes we’ve been watching have also shrunk a bit, but their activity levels are either steady or slightly increasing. There’s a new lymph node in my groin that lit up mildly. The Oncologist believes it’s likely reactive, not dangerous, and probably tied to my recent shingles outbreak.

There’s good news, too. No signs of spread to my liver, spleen, or adrenal glands. All major organs are clear. The kidney stents are holding strong. And the L1 vertebra in my spine, which has been previously affected, remains unchanged. Quiet. And for now, that’s enough.

Now here’s where the story gets more complex.

We also did a biopsy, sampling tissue from the large abdominal mass. Under the microscope, this sample looked different than what we’ve seen before. It didn’t show the Reed-Sternberg cells, the hallmark cancer cells of Hodgkin’s lymphoma that were clearly present in previous biopsies.

The stains, microscopic markers used to highlight specific types of cells, mostly lit up background immune activity. No obvious signs of malignancy.

So what does that mean?

Honestly, it could mean a few things. Maybe we missed the most active part of the tumor with the needle. A negative biopsy doesn’t guarantee the disease is gone. But it also raises the possibility that what’s lighting up on the scan might not be all cancer. It might be inflammation. Or scar tissue. Or cancer behaving in a way that doesn’t follow the rulebook.

If that sounds familiar, it’s because it is. My case has always been labeled “difficult.”

But so am I.

So, we keep going.

My oncologist has asked for a consult with a specialist from Johns Hopkins. I’ll be there next week. The day after that meeting, Team Cooper will regroup and figure out our next steps. I was hopeful about the immunotherapy-chemo combo, but based on what we know now, I’m not an ideal candidate. So we’ll adjust. We always do.

And yeah, I’m a bit pissed off right now.

I’m tired of this not being a normal road. Tired of being the difficult case, the outlier, the one with no clear answers. And what hurts the most? It’s seeing Maria’s face when the word “difficult” gets dropped again in the exam room. That part breaks me, every f-ing time.

But I also know that spiraling into what-ifs or arguing with the data doesn’t help. It doesn’t change what is. It doesn’t move us forward.

So we keep going.

One step.

One scan.

One needle prick

One breath at a time.

I look forward to the day that I step outside the infusion room and ring a little bell. I know that day is coming, I just need to keep stepping.

To all of you who have been praying, sending messages, and offering words of encouragement, thank you. I read every one, and they mean more than I can ever say. Some days, your words are the only thing that quiets the noise in my head.

I know God has a plan for me, even if it’s hard to see the shape of it right now. I’m trusting that each step, even the uncertain ones, is leading somewhere with purpose.

Thank you for walking beside me. I’m not alone in this, and that makes all the difference.