Hopeful Update: PET Scan, Labs, and Keytruda Progress

We’ve reviewed my mum’s latest PET scan and lab results, and there’s a lot to share, some of it may be surprisingly hopeful.

The gastric lesion in her stomach has slightly decreased in activity (SUV down to 3.2).
No new widespread cancer activity was seen.
There’s one small new spot in the retroperitoneal area near the left adrenal gland (SUV 5.0).
Her albumin is normal (44), so ascites or major liver issues are unlikely.
Lymphocytes are a bit lower than before but still functional.
B12 and folate have dropped substantially since starting metabolic therapy.
Monocytes have increased significantly compared to previous labs.
CA125 has only increased slightly — from 290 to 334 over 3 months since starting metabolic therapy.

What these lab changes could mean:

B12 and folate drop:

Metabolic therapy, especially when combined with dietary changes like keto, fasting, and certain drugs or supplements, can increase cell turnover and alter gut absorption. In cancer, a drop in these nutrients can also happen when the immune system is more active, because they are needed for DNA synthesis during immune cell proliferation.

Monocyte increase:

Monocytes are immune cells that can mature into macrophages and dendritic cells — both key players in identifying and attacking cancer cells. An increase can indicate heightened immune surveillance or an inflammatory immune response. In the context of Keytruda, higher monocyte activity could mean the immune system is mobilising against tumour tissue.

Small CA125 rise:

CA125 can go up temporarily when tumours are being attacked and broken down. This small rise suggests there’s no explosive tumour growth and that any increase may be linked to immune or inflammatory activity rather than rapid progression.

Chemo recovery and immune rebound:

My mum stopped chemotherapy last year. Chemo can profoundly suppress the immune system, reducing white blood cell counts and impairing immune coordination. It can take months to over a year for some immune subsets to fully recover. This is one reason why the effects of Keytruda may strengthen over time — her immune system is still in the process of rebuilding its strength and diversity after chemo. The fact that we’re now seeing increased monocytes and immune activity may mean her body is finally regaining the ability to mount a stronger response.

Why the scan might look “worse” before it looks better:

The new PET spot could be cancer… but it could also be immune-related inflammation (pseudoprogression), where immune cells flood a tumour site, making it look bigger or more active for a while. This has been seen in many successful immunotherapy cases.

It reminds me of Joe Tippens’ story. While there’s no confirmed evidence that his scans ever looked worse before improving, we do know he was in a Keytruda trial and added fenbendazole and supplements. Over time, his cancer went into complete remission.

Friday we receive the MRI results to evaluate the progress from the SRS done to the brain around 4 months ago

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