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Lung nodules??

chp's picture
chp
Posts: 23
Joined: Dec 2012
Just got back from onc's office. The 1yr from surgery showed small, 3 and 4 mm -lung nodules. She says we should wait for 6 months and rescan. Does that sound like a reasonable amount of time to wait. Would at PET scan give more definitive results? My cc is signet ring cell. I was 2a, but due to aggressiveness of signet ring, I did receive Xeloda. Is it usual for mets to go from colon to lung? I thought, it was usually the liver first. How often do these things turn out to be cancer? Should I get a second opinion? I know you aren't doctors, but would like to hear opinions.
Thanks,
Cathy

 

Chelsea71
Posts: 1167
Joined: Sep 2012

Sometimes it does bypass the liver.  I would not wait six months (neither would your oncologist if it was him/her in the same situation).  Push for a pet scan.  Insist they rescan in two to three months.

 

Chelsea

geotina's picture
geotina
Posts: 2044
Joined: Oct 2009

Yes, it can bypass the liver and go to the lungs.  Not really that unusual.  If your onc is suggesting wait and see, not so sure about that one.  They are very small  but did show on the CT.   Has your doctor suggested doing a biopsy on them to ascertain if they are cancer or not?  They may be too small but it is a thought.  Wait and see might be the best approach but I would think 3 months rather than 6 months.  It is a tough call.

Take care - Tina

Lovekitties's picture
Lovekitties
Posts: 2893
Joined: Jan 2010

Since you have concerns, how about getting a second opinion from a pulmonary specialist? 

I personally would not feel comfortable waiting 6 months...3 perhaps...in order to see if there is growth especially since your cc is more aggressive.

Bottom line is, when in doubt about what one doc says...get another opinion.  The more info you have, the better.

Marie who loves kitties

oneton0557
Posts: 3
Joined: Sep 2013

Hi, chp.

I'm approaching 3 yr anniv of diagnosis. Met cc - stage 4. My onc was very, very open about getting 2nds. He is also a big fan of patients being proactive about treatment. If your onc does not have your complete trust & confidence, get a 2nd now. Do not wait 6. Met cc is not forgiving, you know.

Best of luck.

J.D.

LivinginNH's picture
LivinginNH
Posts: 1269
Joined: Apr 2010

 

Hi Cathy,

In my personal opinion...I'd be making an appointment with a new oncologist by tomorrow morning since signet ring requires a more aggressive treatment strategy than other types of colon cancer.

All my best,

Cynthia

Fucc
Posts: 84
Joined: Sep 2012

I am currentlynina similar situation. My last scan showed some lung nodes. It looks like five. They are all smaller than 5mm. However, I had some really small spots on a previous scan which indicates that they are likely mets. I was told that the typical standard of care when there are suspicious nodes is to wait three months from their appearance and scan again. This is to remove the possibility that the spots are related to something other than cancer, for example inflammation from a cold or allergies. I would not wait six months. I would also ask to see your ct reports to see if they were previously noted and have grown, rather than just appeared. 

I sought a second opinion and a surgical opinion. My case also went to the tumor board of my hospital. The consensus was that there are too many and too small to deal with surgery or cyberknife. So, it's off to chemo I go in hopes of it stabilizing things and perhaps some of the really tiny ones will magically disappear. The hope is to get to surgery. 

Advocate for yourself. Push for an earlier scan and a second opinion. 

 

 

Fucc
Posts: 84
Joined: Sep 2012

I am currentlynina similar situation. My last scan showed some lung nodes. It looks like five. They are all smaller than 5mm. However, I had some really small spots on a previous scan which indicates that they are likely mets. I was told that the typical standard of care when there are suspicious nodes is to wait three months from their appearance and scan again. This is to remove the possibility that the spots are related to something other than cancer, for example inflammation from a cold or allergies. I would not wait six months. I would also ask to see your ct reports to see if they were previously noted and have grown, rather than just appeared. 

I sought a second opinion and a surgical opinion. My case also went to the tumor board of my hospital. The consensus was that there are too many and too small to deal with surgery or cyberknife. So, it's off to chemo I go in hopes of it stabilizing things and perhaps some of the really tiny ones will magically disappear. The hope is to get to surgery. 

Advocate for yourself. Push for an earlier scan and a second opinion. 

 

 

Happyhar
Posts: 49
Joined: Apr 2010

My Colon Cancer that metastasised to my lung(right upper lobe) was Adenocarcinoma. Colon surgery was Dec. 09 followed with 8 months of Folfox 4 and 6. CEA started climbing Nov 2012 thru June 2013. Had CT, PET, Colonscopy, Endoscopy etc and then VATS (video asisted thorasic surgery) July 31st 2013. The nodule was 2cm. Surgery went well and now I am about to begin 6 months of oral chemo called Xeloda. At present there is no other evidence of problems. The Xeloda is a simi-agressive approach. Some say do nothing until something else appears and others say go with infusion chemo as a possible deterent to new metastasis. May God bless and comfort you as you make these decisions

annalexandria's picture
annalexandria
Posts: 2181
Joined: Oct 2011

I have been in "watch and wait" mode for a couple of years now.  I was being given PET/CT scans every three months; because the PETS are so sensitive if something showed that didn't have a very high SUV (indicating rate of cellular activity), we would wait for the next scan to see what was going on.  When something got big enough to show up on the CT part of the scan (backed up by the PET findings), then it was off to surgery.

The PET would indeed help to indicate whether or not these little things are actually cancer.

If it was me, I would want a PET, and a rescan with both PET and CT in 3 months.

Just be forewarned, the PETs are pricy and many insurance companies balk at doing them.  I had to threaten mine with legal action before they would pay for it (and this was after it had been definitively proven that the CT was unable to pick up my tumors until things were very advanced).

If you can get an onc on your side to help push for this approach, it may help.

Good luck!  And keep us posted on how things go.

AA

janderson1964
Posts: 1526
Joined: Oct 2011

Sometimes they do an MRI and sometimes they do a PET scan to get more definitive results. I have done it both ways. Most recently I had a tiny spot show up on my liver and they did an MRI to confirm but was inconclusive. I had a choice to do a needle biopsy or rescan in 3 months to see if there are any changes. So I think a PET or MRI wouldn't hurt except for your wallet but I wouldn't wait more then 3 months if you are going to take the "wait and see" approach.

chp's picture
chp
Posts: 23
Joined: Dec 2012

Thanks all for the good advice.  I've decided to get a second opinion.  I haven't felt very comfortable with my oncologist's approach up til now.  She doesn't seem to think the signet ring cell should make me feel concerned.  Of course that's easy for her to say.  Have already had my med records sent for an appt for 2nd opinion, hopefully will hear from them soon.  Will let you know what I find out. Thanks again! Everyone here Is so helpful!

Cathy

janderson1964
Posts: 1526
Joined: Oct 2011

Good for you. I was very comfortable with my oncolgist for the first 6 years of my fight then he made some decisions I did not agree with so I changed oncologist. My second oncologist upset me even more than my first one so I am done with him as well. Right now I am doing follow scans with my surgeon and will not dal with an oncologist until if and when I need one.

Coppercent
Posts: 142
Joined: Jan 2012

Glad to hear you are getting a second opinion.  I would be uncomfortable waiting for 6 months to be rescanned.  We were on a wait and see on lung nodules but my last CT scan in May showed abdominal nodes.  Against my better judgement I had a PET scan.  I had wanted to go straight to surgery on the abdomin but I agreed on the PET. I just didn't think a PET, another scan was necessary and  I was right.  The PET showed the exact nodes lighting up in my chest and abdomin that the CT did so we went with a Bronchoscopic biopsy tosee for sure if the lung nodes were cancer or not.  Luckily the nodes in my chest were not cancer!  I had the abdominal surgery and the two nodes that lit up were cancer.  While the surgeon was in there he looked around and found 4 other cancer nodes that didn't show up on either the CT or PET. We think we got them all now.  On anothter note.....my CEA since diagnoses has always stayed a 3 which for the test they do is in the normal range. My last CEA was a .56.  My sick mind is allowing me to think all of the cancer is gone now.  It keeps me in my happy place. Laughing 

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