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New Scan

callerid
Posts: 99
Joined: Dec 2012

Had a good scan (I think). Lymph nodes decreasing  And the metastactic bone disease has not changed significantly.

The doctor feels the current chemo is working. He took him off one drug because it was causing myelosuppression: delaying his treatments to three weeks or more.

We got the report as we were leaving the doctors office. It would be nice to see it ahead of time or during the appointment so we could ask questions about the results. It is difficult to put all of this in context. The report said, There is persistent increased FDG within the distal esophagus and FDG uptake in these lymph nodes has resolved.  What I think that means is the esophagus is still churning out cancer cells, but the chemo helped the lymph nodes. 

Can anyone explain any of this more clearly?  Does it mean the chemo helped the wandering cells but left the primary untouched?

Thanks

JKGulliver
Posts: 83
Joined: Apr 2013

I'm not a medical professional, but I've been learning alot these days.  FDG is the glucose molecule used in PET scans.  Cancer cells uptake (draw up or absorb) more FDG than normal cells.  This indicates their higher level of metabolic activity.  This is what is meant by "hotspot", or "lit up" on a PET scan.  In lots of imaging, the color is actually yellow.  

If you are looking at a pictue of the esophagus, the lower left third is called the distal esophagus.  

So, the report says that FDG uptake is persistently higher in the lower third of your esophagus compared to normal cells.

When cancer is "resolved" it means that there is no detectible difference between the metabolic activity of the cancer and normal cells as measured by the FDG.  I agree with you.  It seems the chemo has arrested the metabolic activity of the cancer in the lymph nodes.  This is good.  It means they are not dividing.  I don't believe the lymph nodes wander, however.  

callerid
Posts: 99
Joined: Dec 2012

Thank you for your response.

So are you saying that even though the EC cells metastisized to the lymph nodes they generally stay put and don't wander to other areas of the body as they enlarge.

Do they know why EC takes different paths of metastisis. Currently it has been in the spine (resolved by radiation) the lymph nodes in the neck and also in the pelvis. Others on this board have mentioned their EC spread to lungs and/or liver. 

eternalife
Posts: 36
Joined: Apr 2013

Hi all,

My husband was diagnosed with stage iv EC, Her 2+, Dec. 2011 has taken chemo, initally there were a few cancer cells in the lymph and a mass in the right rib. After one round of chemo, there was NED in the lymph nodes and rib.. in over a year now, the scans still show NED there, he just had a scan yesterday to check on the activity in the primary site , the esophagus as the last scan showed a wall thickening. He finished 5 weeks of radiation last month.

Please keep posting as it sounds we have very similar stories.

Thanks

JKGulliver
Posts: 83
Joined: Apr 2013

You should ask your oncologist to be certain.  But, from what I understand, there are many lymph nodes all over the body.  They do not wander around the body.  I've been told by doctors there is a large lymph node that winds AROUND the esophagus and is often involved in the type of EC my husband has.  It does not wander around either before or after being affected with cancer.  At least, this is how I understanding things.  This particular lymph node is usually targeted by the radiation oncologists along with the esophagus if radiation is part of the treatment.  

Is there any way you might be talking about lymph which is the fluid that travels around the lymph node system?  I have heard people talking about cancer cells being sent around the body by lymph.  It is delivered to other lymph nodes this way.

We've asked alot of questions about metastisis.  The way it was explained to us is that common sites for reoccurance are the liver, stomach, lungs and the site where the stomach is attached to esophagus if there was surgery done.  It can go anywhere, however.  One doctor said that cancer cells send out proteins at the microscopic level.  They look for favorable places to prepare "microenvironments" for cancer cells.  These become future sites for tumors.  It is so very weird then EC reoccures in another location.  If is reoccures in the lungs, for example, the patient does not have lung cancer.  They have EC, in the lung.  

It has been a long learning curve for us.  And we get bogged down by the terminology.  You have to check with your doctor to be sure.

eternalife
Posts: 36
Joined: Apr 2013

Hi Jk Gulliver,

Thanks for the explanation on the lymphatic system. My husband's first PET scan showed there were a few lymph nodes affected, beside the primary site the esophagus as well as the 11th right rib, there was a mass. He tested + for the HER2 gene. As I undrstanding because he carries the gene, it overexpresses and creates a breeding ground so to speak for cancer cells , which began in the- esophagus, unfortunately the PET was not done early enough to make it a lower stage diagnosis. He did try Herceptin the chemo drug that targets the HER 2 genes, the rib mass and lymph nodes showed NED after he took Herceptin, hence the docs have stated something did occur to cease the activity in these two areas.. that was our good news.  I just keep praying that the cancer will not spread to the other organs because that  can create a huge problem.

There is so much to learn about EC and I hope one day it will no longer exist for anyone. Please keep posting any information you may feel is helpful to all of us here.

Thanks,  

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