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First Scan after surgery is in - not what I was hoping for...

Phil64's picture
Phil64
Posts: 476
Joined: Apr 2012

I'm curious if any of you have had similar results and/or what you all think about these results???

Yesterday I went for treatment 8 of 12 of FulFox. I also saw the doctor as a follow-up for PET and CT Scans done on 10/1. The scans show a small nodule (3mm) in the lower lobe of the right lung. The doctor thinks it might be related to inflamation; however he couldn't rul out it being a MET of the colorectal cancer. He doesn't think its cancer because it was not well circumsized and the PET scan didn't show uptake. A tumor that I had that was surgically removed on 6/1/2012 was also in the lower lobe of the right lung. That nodule was 12mm when it was first detected and 18mm when it was removed.

I will receive another CT scan in six weeks. If that CT scan shows growth in the nodule the doctor will recommend another lung resection surgery to remove and biopsy the nodule. He said if the nodule is from inflamation it will likely not be present in another six weeks. If the nodule turns out to be cancer I will stop the FolFox chemo treatments (e.g. they are not working) and a new treatment plan (likely Irinotecan) will be developed.

We also discussed CEA levels in the followup with the doctor. I went from 19.7 CEA to 3.7 CEA post surgeries (colon and lung resection). Since then my CEA level has climbed to 8.9 and seems to have stabelized at this level. The doctor also said that a Lung MET of this size would likely not cause CEA level jumps like this. So he is still leaning towards the CEA level increase being related to the chemo; not a sign of tumor activity.

The other organs (colon, liver, etc) did not show any tumor activity.

Yesterday's treatment included a reduced amount of oxaliplatin. I didn't have the cold sensitivity or the jaw pain so far... I suppose that is a good thing? But I was surprised by this, especially given the cumulative effect given that this is now treatment 8.

What do you all have to say? Is the nodule an inflamation or a tumor? Is it possible that the CEA Level increase is an indication of tumor activity? Or have any of you encountered the CEA level increase from the folfox chemo?

Orinotcan

luvinlife2
Posts: 172
Joined: Jul 2012

My CEA has spiked after a chemo treatment. This is because of the cancer dying and releasing the same proteins when it is proliferating. Inflammation in the body can also cause the CEA to rise. I think what your oncologist told you is very reasonable.

:)

Lovekitties's picture
Lovekitties
Posts: 2951
Joined: Jan 2010

Your scan news may not be what you were hoping for but it does contain good news...no tumor activity in the other organs. That is very good news.

As for the lung 'spot', with no uptake being detected, that is also good news.

I know that the CEA numbers can be worrisome and waiting for 6 weeks will seem forever to get more definitive answers, but some times waiting is all we can do. Unfortunately CEA numbers can fluctuate due to other causes. If yours seems to have leveled out, that is good too even if not an optimum number.

Until then concentrate on all the good news you got, and save the worrying for later if something does show up.

Hugs,

Marie who loves kitties

Kathleen808's picture
Kathleen808
Posts: 2308
Joined: Jan 2009

Hi Phil,

I don't have any answers to your questions but I can tell you that I know other folks have had CEA jump around for reasons other than cancer growth. I think the key may be making sure you have docs that you really trust. If that is the case, I think going with what he said is a sound idea.

Best to you.

Aloha,
Kathleen

smokeyjoe
Posts: 1428
Joined: Feb 2011

I guess there isn't much you can do but stay on the current course and see what that nodule does, your oncologist seems to already have other treatment plans in place if it is in fact a met...that's great they are willing to do surgery to get rid of it, probably follow up with a different chemo. regimine. Waiting is so friggen hard....

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

so just trust your intuition.
time will tell, so if the possible lung met disappears great,

the issue to contemplate is what rising cea's over a few months mean and then what options.

i got caught by surprise when the suckers turned up lung, liver, peritoneal.

its not advice , but i wish i had an angio ct and the mri primovist earlier.

possibly earlier detection of any mets might allow any surgery a greater chance of working.

hugs,
Pete

janie1
Posts: 753
Joined: Apr 2011

Phil, i just read what you wrote to me on the other thread......i had a disappointing scan, too.

I know it's a huge let-down, but for you, focus on these positives
..... you just have one very small spot, let's say it is cancer.....could they possibly do RFA on it, instead of surgery. With RFA they also go for clear margins. RFA is, i hate to say it......but it's easy. Do you know about it? They stick a needle into the tumor (CT-guided). Then the tumor is heated (and fried!!!). Being able to do RFA depends on the location.
If they don't do RFA, ask why not. Obviously, you want to follow the "experts" recommendations. Are you going to a really good place??

.....if they have to do surgery.....well, at least they can, and they aren't saying it's inoperable.

.....If you have to do chemo.....folfox is probably the worst. Folfuri (at least for many people) isn't so bad. And if you can do Erbitux, that's just another weapon in your arsenal.
I am surprised that your doctor has not checked the KRAS status until now to see if you can take Erbitux, that's why I'm questioning whether you are at a really good place. If you are comfortable with it, that's great. We Stage 4's just can't mess around with anything sub-par.....if you know what I mean.

Hang in there, Phil. It's bumpy now....but hopefully there will be smooth days ahead.....pretty soon. This is a crappy disease. I, too, have a lot of conversations with God. So far, I'm fairly sane. As you know, none of us are completely in control, but we sure can do our part. Every time I get stuck with a needle, feel icky, have to hear dumb comments, and on and on......I always tell God I'm doing it for his Glory.
I'm a better person, more observant to want to go out of my way to help someone, more compassionate to anyone with any sort of physical or mental problem, more empathetic and appreciative of the elderly.

You're a good man, Phil. We're all in this together. I love this family.

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