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First Scan after surgery is in - not what I was hoping for...
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Oct 05, 2012 - 1:32 pm
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 |
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.
:)
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
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
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....
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
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.