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using PET to diagnose

psulefty
Posts: 2
Joined: Mar 2011

My doctor found a few shadows on a chest xray that lead to a few small nodules (7 - 9 mm) being found on a CT scan. He wants me to wait 2 months for the next CT scan to see if they've grown, an indication, according to him, that they're cancerous. While I understand the logic of "growth" what I don't understand is his being firmly against doing a PET/CT scan. From my understanding, that would identify if there are problems elsewhere and the lung nodules were metastzied from somewhere else or primary to the lung (or maybe even benign?). He said that "we never do that". Is he making sense, or just passing me off? Any thoughts? (thank you in advance)

PBJ Austin
Posts: 346
Joined: Mar 2009

Anytime you are uncomfortable with your doctor's advice you should get another opinion. And get it from a doctor completely unaffiliated with your current doc. I don't understand why they aren't doing a biopsy yet, that's what I would ask for.

I am not an expert on lung cancer but growth doesn't necessarily mean it's cancer. Afer my first CT scan they found a large mass and the ER doc was sure it was lung cancer. After 3 biopsies they decided it was not cancer but they didn't know what it was so they removed my upper right lobe as it was already destroyed. It turned out the mass was a bad infection. Of course I cannot tell you with certainty that is the case for you, I honestly don't know.

I do know that PET scans detect any abnormal growth and can sometimes give false positive results for cancer. The mass in my lung did light up as if it were cancer, but that was after I had 3 biopsies and cancer was already ruled out. They did the PET scan on me to make sure there wasn't cancer elsewhere and there was not. The possiblity of false positive results could be the reason the doc is hesitant to do the PET, but I still think you should seek another opinion.

Good luck.

z's picture
z
Posts: 1251
Joined: May 2009

Hello, I was originally dx with anal cancer on 5-4-09, so I had follow up pet/ct scans to moniter for mets. Well on 5-2010 with a follow up pet/ct a 7mm nodule was found in my lower right lobe. So like you will be, I was rescanned on 8-2010 and the nodule had grown to 11mm. At this point the tumor board said this must come out. It wasn't dx as a primary lung cancer until it was biopsied in the OR on 9-23-10, whereas, at that point the entire lobe was removed. Now my follow up CT with contrast on 1-18-11 was clear. So I guess to answer your question the follow up CT scan will shown a lot. As they can also see your liver and kidneys when they do the thorax ct.

My original pet/ct which showed the 7mm nodule showed an suv uptake of 2.1 which isn't that high. Normal would be 2.5 and under, and sometimes pet scans show suv uptake in infections too. So the only way to tell if its cancer is to biopsy it. And if your dr doesn't explain everything to you where you feel comfortable you should get a second opinon. I wish you well Lori. Please keep us posted.

psulefty
Posts: 2
Joined: Mar 2011

Thank you both for your comments. Having just started down this path, and reading all of these posts for the first time, I see both amazing strength and compassion. Through it all, my guess is that they will be the two most important characteristics to possess.

soccerfreaks's picture
soccerfreaks
Posts: 2801
Joined: Sep 2006

To be honest, the reason they wait, typically, is to see if what they detect as an anomoly grows. There are indeed lots of reasons for 'shadows' in the chest, in the lungs, especially if you are or were a smoker, if you have had pneumonia or bronchitis, or even a lung infection. Waiting is, indeed, the hardest part, but sometimes it is necessary if you want to avoid unnecessary and even invasive treatment.

Incidentally, most cancer survivors will tell you that they get their PET or CT scans only every three months or so, at least at first, and it is for the same reason: cancer takes time to grow.

If it isn't growing, there is no reason to go digging around in there.

If it small but growing, they will want it to grow to an extent that they can establish what kind of cancer it is, whether it is primary or metastasis, and how fast it is growing.

No hurry. No worry. Usually.

Best wishes. And if you DON'T trust him, then get another doctor, although it sounds like you are not apt to trust any of them until you learn some patience.

Take care,

Joe

congoody
Posts: 74
Joined: Jan 2010

Telling someone "we never do that" instead of explaining WHY "we never do that" is reason enough to get a second opinion - My original chest xray was followed quickly by CT and then in a few days a PET/CT - result was lobectomy to confirm a stage 1A tumor that did not require further treatment aside from close follow up -
If you are not comfortable, that is reason enough for a second opinion, not for finding a way to "learn some patience".
Connie

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