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mri scan

kutatunaz
Posts: 5
Joined: May 2021

I had a large colon cancer tumor removed in December. A pet scan showed that I have a metastasis in my liver and another in a lymph node. They sent me for a mri scan and it revealed that I have another 15 small lesions in my liver. They called them colon cancer metastases. Without a biopsy, how would they know that these lesions are cancer?

Tueffel's picture
Tueffel
Posts: 310
Joined: Feb 2020

The best way to know if these lesions are cancer is indeed biopsy. But unfortunately the most common liver cancers are metastasis. Tumors, good or bad, originating from the liver directly are less often than metastasis. MRI is very sensitive,my dad had a mets that was initially 2.3mm big. I think for PET the lesions need to be bigger unfortunately. 

But also MRIs can be wrong and some benign lesions might look like cancer but isnt. But what if the doctors say it is not a metastasis but something benign, they wont treat you and then during the next scan they figure out that it is bad because it grew faster than benign lesions do? Radiology especially in oncology is the most difgicult part in medicine and sometimes you are safer when they apply the worst case scenario. 

I wish you good luck in your treatment. Keep us updated on what the doctors will decide. 

Tueffel

kutatunaz
Posts: 5
Joined: May 2021

They operated on me Dec. 11 and removed the tumor in my colon as well as 16 local lymph nodes for testing. Three of the lymph tested positive for cancer. The doctor also saw a dime sized spot on my liver. He sent me for a petscan and they found two hotspots, one in the liver that the surgeon had seen and another lymph node in my groin area. The metatasis in the liver was near the edge and determined to be operable. I was then sent for an mri. The radiologist reported another 15 small metatases in the liver that didn't show up on the petscan. They were determined to be non resectable. If these lesions are indeed cancer, there is little hope. If they are actually benign lesions, the metastasis can be surgically removed and chemo can be used to eliminate any random cancer cells in my body. I need to know what I need to do to determine if the lesions are benign or malignant. The malignant tumor first discovered was 15 mm by 11 mm. The other 15 are about the size of a kernel of corn, the largest being 12 mm by 11 mm.  

abita's picture
abita
Posts: 1069
Joined: Dec 2017

Pet scans can pick up foci cancer cells. This is why they do the PET scan before confirming the treatment plan. They want to see ALL the cancer cells, even the tiniest of them. 

Real Tar Heel
Posts: 252
Joined: Nov 2019

We can't really tell you what to expect but I don't know about the "little hope" part. You haven't said how large the 15 tumors are in the liver, etc. They may not want to do surgery right now because of the number of them or their location within the organ. Chemo may shrink them and then you can discuss surgery again. You may be in for the long haul on chemo. It is too early to tell. It would be great if they are benign. Good luck.

kutatunaz
Posts: 5
Joined: May 2021

The 15 tumors in the liver are all less that 1 cm. Several websites says that pet scan is not good at detecting metastases that small and that mri is a better indicator so I suppose my hope that they are benign is a vain one. The oncologist just says that are doing chemo in hope of shrinking the lesions and I don't understand the purpose if they are already that small.

Real Tar Heel
Posts: 252
Joined: Nov 2019

You can speak with the surgical oncologist more about this but the number and location are a factor in their decision to do surgery. They may believe they would have to remove too much healthy tissue with surgery at this point. I have 4 that size and one larger one and the tumor board is recommending chemo before surgery (if at all), so I don't see their decision as out of bounds. But as you will find out by reading around the board people have much worse and are still going thanks to chemo. Getting another opinion at another facility might provide some clarity so you may want to go that route but you might also want to consider time as factor. Hopefully things will work out for you.

abita's picture
abita
Posts: 1069
Joined: Dec 2017

When I had my recurrence, right after my mop up chemo, they truly believed with the CT scan that it was scarring. 
With the MRI, they had no doubt it was recurrence. So somehow they know. They do a lot of training and see a lot of cases. '

They then sent me for a pet to see if there was any spread too small to be seen with the other scans.

Not sure if it is the case for you, but with my original diagnosis, my surgeon did not biopsy the liver lesions because he knew from his 40 years of experience that they were cancer so why risk seeding the cancer and causing more spread. At least I think that is what he said. My head was still overwhelmed back then and foggy from the first surgery and everything going from great life, to what!?!

Don't let "no hope" get in your brain this early in the process. I was supposed to be curable, and here I am, chemo for close to 4 years. But I get up every day, and I live a joyful life, way more fatigued than before, but I am still here. And I am "stable" and my "hope" is that the drug that can "cure" me is discovered. I even went to Mardi Gras, in the French Quarter, while I was getting FOLFOX, on the desentization protocol, so while I hope for you, that those are benign and that your road to cured is easy and quick, please remember if the path is harder, there is always hope.

flutemon's picture
flutemon
Posts: 41
Joined: Jan 2019

There are a number of liver specific treatments that are offered.  I've had surgery, ablation, sbrt (focused radiation) and am getting ready for radioembolization (Y90).  I had considered HAI (hepatic arterial infusion) pump, too, but I also have lung mets so it is off the table. The latest thing for liver only mets is living donor liver transplant. 

I say all of the above so that you know there are many things that can be done to tackle liver mets.  The gold standard for cure is resection.  But in the case of bilobar mets, which is what I had/have, there are many things that can be done. I'm 3-1/3 years from diagnosis, and still living with HOPE!!  Many of the treatments and drugs used now were not readily available 5-10 years ago.  I consider my stage 4 colon cancer to be a chronic condition, like my type 2 diabetes and high blood pressure.   And I keep living each day to it's fullest.

Hold on to hope!

abita's picture
abita
Posts: 1069
Joined: Dec 2017

I am with you. I was supposed to be cured with surgery, but got an immediate recurrence that was not operable as too close to some vein or something. I am doing my infusions, and just waiting for my miracle drug to be discovered and living life while waiting, enjoying my loved ones, etc.

I think what is super frustrating really is how chemo shrinks my liver mets to too small to be seen on CT, but these darn lung mets just stay "stable" argh!

kutatunaz
Posts: 5
Joined: May 2021

Has anyone here had experience with disappearing liver metastses? Before beginning chemotherapy, my doctor sent me for an MRI of my liver. They found 15 colon cancer metastases. After six rounds of treatment, I underwent another MRI. Two of the lesions have shrunk by about 85% and the other 13 disappeared completely from the scan. What are the odds that the lesions are really gone vs the chance that they are simply too small to show up on the results?

Real Tar Heel
Posts: 252
Joined: Nov 2019

See abita's reply to your earlier post. Some types of scans can visualise the hot spots and tell if there are maglignancies CT scan can't pick up.

abita's picture
abita
Posts: 1069
Joined: Dec 2017

Yes, last pet scan I had showed the liver had foci tumor cells remaining.

kutatunaz
Posts: 5
Joined: May 2021

I don't think pet scan will do it. These 13 metastases never showed up on pet scan even before they disappeared. They were only discovered by MRI and they disappeared from my most recent MRI scan. The only metastasis that showed as a hot spot on my pet scan was one of the two remaining.

kenlyon01
Posts: 1
Joined: Jun 2021

My doctor just informed me that a routine colonoscopy revealed cancer. I did a ct scan of the pelvis and chest, and it appears to be ok so far. I am waiting on a call for an MRI now. Does anyone know if medicare handles this?

 

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