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CT scan results questions

chrisehill
Posts: 7
Joined: Feb 2010

Just wanted some advice on some of my moms results. Our oncologist is very brief when discussing results with my mom. He doesn't explain things very carefully enough so that when I take the CT scan results home, I have more questions than answers. Here are some examples.

1)The small sub-centimeter rounded sclerotic lesion within the posterior aspect of the L1 vertebral body is stable as compared to multiple prior exams. There are degenerative changes in the lower lumbar spine.

2)There are bilateral adnexal lesions. There are stippled areas of calcifications within both of theses locations. The right adnexal lesion has increased in size, today measuring 6.4x5.8 cm as compared to 3.5x3.3cm from the last exam.

3)There is a small lymph node measuring 0.6cm in short axis diameter posterior to the trachea within the upper mediastinum.

4)There is a small cyst in the right kidney measuring less than 1cm

5)There is a small lobulated nodule in the inferior aspect of the right upper lobe today measuring 1.1x0.9cm which has enlarged slightly since the prior exam.

6) The 1.5cm mid right hepatic lesion is stable. There are no new liver lesions.

My mom has been diagnosed with metastic carcinoma with liver mets. She has had 24 rounds of chemo. 5FU, Leucovorin, Irrinotecan, and Avastin. These test results came after she had a 2 month break from chemo. How would you guys rate these results?

Sundanceh's picture
Sundanceh
Posts: 4408
Joined: Jun 2009

Hi Chrise

From what you described, I offer you my thoughts on your subject:

1. Was there Cancer in the L1 vertebra before? The report says to me that things are "stable and unchanged" since your last exam. I would take this as a positive. We all have degenerative conditions in our spine - especially if we had radiation, and just plain, good old fashioned aging. I've got degenerative conditions in my back as well.

2. Sounds like there is some growth her and that's not a small spot, it's significant to worry about and keep a tight watch over.

3. Not sure what to make of this one. I had uptake activity in my trachea and voice box, but it turned out to be nothing. Still we need to keep an eye here as well.

4. No worries here - just about every human being has a small cyst on their kidneys, one of my surgeons included. This is considered normal - however, we want to keep an eye on this each scan cycle to see that it remains unchanged.

5. Small increase here, so the chemo has definitely slowed down the progress compared to your last scan cycle - despite a small increase, this is good news - it means that the chemo has kept the cancer at bay and it is not growing exponentially - without treatments, this certainly would have grown out of control. A victory here, despite the small growth - this will be where the battle will be fought - I'd see about keeping her on Avastin and Xeloda to throw some preventative measures at this to keep things in check.

6. Another battle area, but another good victory, since the area is stable, with no new growths - no growth is spreading is a victory, indeed.

Overall, I would say this is a favorable report, with a few things that we want to keep a close eyeball on for each scan cycle.

For peace of mind, you might want to consider getting a 2nd opinion from a new oncologist - you might find a better and open relationship with the new doc, and the new opinion will give you an idea of where you are at - and you can compare apples to apples, oranges to oranges, to see if you feel like they are seeing the same thing.

TRUST is a huge thing between patient and oncologist - you must believe what they are telling you and it's nice to be able to have a "give and go" with the doc to answer your questions and concerns. What I might also suggest is typing up questions in advance - then fax them over to the doctors office in advance of the appointment. Then you walk in with your copy and let the existing or the new guy right up front, that we are going to talk about this and that you are taking a more pro-active approach with future healthcare. If the existing guy hesitates or balks, there is your answer - TIME TO WALK.

You must stay an advocate of the healhcare and let them know that you are nobody's dummy and that this is serious business - the business of Life and Death - and you want due consideration of that or you are leaving. Use this approach with the new onc until you click with one you like and trust.

I think she is going to have to get back onto chemo to keep things stable, and I would ask about what conditions need to be met for a liver resection, or an RFA or CyberKnife procedure.

I hope this is of help to you - take care and do post back what you find - I'd be interested to know for sure.

And BTW, Welcome to the Board, we are glad to have you here and will do anything that we can to alleviate your fears and concerns, and try to help you as much as we can with what we know and have experienced. So many educated people here - and we've all been through this and try to support one another any way we can. So welcome home, and ask any questions that you have. Look forward to hearing from you.

All the best going forward!
-Craig

Buzzard's picture
Buzzard
Posts: 3073
Joined: Aug 2008

and pretty much ditto what Craig has told you...Love and Hope for you and mom.....Buzz

chrisehill
Posts: 7
Joined: Feb 2010

This was the first time any activity was reported in her L1 vertabra. I just reviewed her last CT scan result and it makes no mention of it. I take it as a sign of mets growing in her spine.

msccolon's picture
msccolon
Posts: 1956
Joined: Oct 2004

Keep in mind that radiologists are human and some tend to be very wordy and some aren't. It could be that there was degeneration showing in the L1 vertebrae before, but the radiologist didn't mention it cause he didn't consider it significant. What I always do when I get a scan and want to know what the $100 words mean is type them into the google search and see what comes up!
mary

dianetavegia's picture
dianetavegia
Posts: 1953
Joined: Mar 2009

I think number 2 is ovarian cysts, are they not?

chrisehill
Posts: 7
Joined: Feb 2010

The onc believes it to be cancerous due to the fact it increased in size while she was on a chemo break.

dianetavegia's picture
dianetavegia
Posts: 1953
Joined: Mar 2009

Is she in menopause?

chrisehill
Posts: 7
Joined: Feb 2010

She is 56

chrisehill
Posts: 7
Joined: Feb 2010

She is 56

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