2 mm lung nodule

star chaser

I am a 3 yrs ned from IV . I had 8 tumors in liver and they are still dead from combo rfa and resection. This little nodule that showed up is being called a mucas plug anyone else have that happen. they say its not likely mets because its only one.
Of course I just have to wait till next scan in sept.
I also heard the lung mets dont put off as much cea is that correct? I know everyone is different on this but my cea was a indicator during treatment.

snommintj

Keep an eye on it
Keep an eye on it. I wouldn't wait until september. See if you can get a CT in a few weeks.

taraHK

lung met
I can't help on the CEA issue -- I am one of those people whose CEA was never elevated.

Of course I hope 100% that your nodule turns out to be "nothing" (ie not a met). However, I do feel I need to share with you that I have had a solitary lung "spot" which turned out to be a met (on several occasions). I sure hope this is not the case with you.....

Good luck.

Tara

Patteee

CEA indicator
The CEA is confusing to me- probably because my own treatment team could not agree on it. My surgeon is at Mayo, my oncologist in Mpls. Saw the surgeon in Dec for testing for the colostomy take down, she did the marker test then, it came back elevated but still within normal limits. She said not a big deal, something my oncologist would watch in the upcoming months. I then saw him several weeks later (I was still getting chemo) told him about my Mayo trip and elevated CEA. He wanted to know why she did a CEA? That I was still undergoing chemo and the CEA is not accurate, not a good test while getting chemo.

shmurciakova

Patteee said:

CEA indicator
The CEA is confusing to me- probably because my own treatment team could not agree on it. My surgeon is at Mayo, my oncologist in Mpls. Saw the surgeon in Dec for testing for the colostomy take down, she did the marker test then, it came back elevated but still within normal limits. She said not a big deal, something my oncologist would watch in the upcoming months. I then saw him several weeks later (I was still getting chemo) told him about my Mayo trip and elevated CEA. He wanted to know why she did a CEA? That I was still undergoing chemo and the CEA is not accurate, not a good test while getting chemo.

lung mets
Hi, I hope that your little nodule turns out to be nothing. I am surprised they could even see something that small. Your CEA will be monitored over the coming months and if it continues to rise over a period of time you will want to speak to a thoracic surgeon about a biopsy. Otherwise, if it remains stable and your CEA does not rise then you can assume it is nothing.
I really hope that turns out to be the case. I had 2 small lung mets removed sucessfully, so if it does come to that it does not mean you are doomed. 8 months passed between the time they were first seen and the time I had them removed. Speaking from experience I don't think that waiting until September to be rescanned is too long. They cannot even remove a nodule that small anyway and it certainly would not light up on a PET scan even if it is a met. They waited until mine were around 1cm before they wanted to operate on them. There are several of us out there that have had lung mets removed and have survived and thrived!
Good luck,
Susan H.

HANRSC

Hello
In May underwent surgery to remove a small lung met. My normal CEA was around 2.14 and did not increase. After my surgery I received 2d opinion from another oncologist...he stated the CEA marker may or maynot increase because its reference marker is from the original Colon resection & MET to liver. In July 2009 I found that after consulting 3 oncologists prior to surgery that none told me about the study indicated below.

Colon Cancer News
http://patient.cancerconsultants.com/colon_cancer_news.aspx?DocumentId=43613#_ednref1

Surgery Unnecessary for Most Patients with Metastatic Colorectal Cancer
CancerConsultants.com - News 6/2/2009
Patients with newly diagnosed metastatic colorectal cancer do not need to undergo surgical removal of their tumor unless the tumor is causing complications, according to the results of a study presented at the 2009 Annual Meeting of the American Society of Clinical Oncology (ASCO) in Orlando, Florida.[1]
Colorectal cancer remains the second leading cause of cancer deaths in the United States. Metastatic colorectal cancer refers to cancer that has spread from the colon to distant sites in the body. Historically, standard treatment for metastatic colorectal cancer was removal of the primary tumor at the time of diagnosis. This was not to extend survival, but to prevent future complications that could be caused by the tumor.
However, many new chemotherapy drugs have proven effective in the treatment of metastatic colorectal cancer, and physicians have begun to speculate that surgical removal of the primary tumor is unnecessary and may carry more risk than benefit. Furthermore, immediate surgery often results in the delayed use of chemotherapy.
Researchers at Memorial Sloan-Kettering Cancer Center conducted a retrospective analysis of 233 consecutive patients diagnosed with metastatic colorectal cancer between 2000 and 2006 whose symptoms did not warrant immediate surgery. The patients were treated with one of three triple-drug regimens (FOLFOX, IFL, and FOLFIRI) with or without the addition of the targeted agent Avastin® (bevacizumab).
The results indicated that the majority of patients (93%) never developed complications that necessitated surgical removal of their tumor. The researchers concluded that most patients with metastatic colorectal cancer who receive immediate treatment with chemotherapy never require surgical removal of their tumor. They suggest that chemotherapy should be the standard of care for patients with metastatic colorectal cancer who do not have obstructed or bleeding colorectal tumors.
Reference:
[1] Poultsides GA, Servais EL, Saltz LB, et al. Outcome of primary tumor in patients with synchronous stage IV colorectal cancer receiving combination chemotherapy without surgery as initial treatment. Presented at the 2009 annual meeting of the American Society of Clinical Oncology, May 29-June 2, 2009, Orlando, FL. Abstract CRA4030.
Copyright Colon Cancer Information Center on CancerConsultants.com

Surgery Unnecessary for Most Patients with Metastatic Colorectal Cancer
CancerConsultants.com - News 6/2/2009
Patients with newly diagnosed metastatic colorectal cancer do not need to undergo surgical removal of their tumor unless the tumor is causing complications, according to the results of a study presented at the 2009 Annual Meeting of the American Society of Clinical Oncology (ASCO) in Orlando, Florida.[1]
Colorectal cancer remains the second leading cause of cancer deaths in the United States. Metastatic colorectal cancer refers to cancer that has spread from the colon to distant sites in the body. Historically, standard treatment for metastatic colorectal cancer was removal of the primary tumor at the time of diagnosis. This was not to extend survival, but to prevent future complications that could be caused by the tumor.
However, many new chemotherapy drugs have proven effective in the treatment of metastatic colorectal cancer, and physicians have begun to speculate that surgical removal of the primary tumor is unnecessary and may carry more risk than benefit. Furthermore, immediate surgery often results in the delayed use of chemotherapy.
Researchers at Memorial Sloan-Kettering Cancer Center conducted a retrospective analysis of 233 consecutive patients diagnosed with metastatic colorectal cancer between 2000 and 2006 whose symptoms did not warrant immediate surgery. The patients were treated with one of three triple-drug regimens (FOLFOX, IFL, and FOLFIRI) with or without the addition of the targeted agent Avastin® (bevacizumab).
The results indicated that the majority of patients (93%) never developed complications that necessitated surgical removal of their tumor. The researchers concluded that most patients with metastatic colorectal cancer who receive immediate treatment with chemotherapy never require surgical removal of their tumor. They suggest that chemotherapy should be the standard of care for patients with metastatic colorectal cancer who do not have obstructed or bleeding colorectal tumors.
Reference:
[1] Poultsides GA, Servais EL, Saltz LB, et al. Outcome of primary tumor in patients with synchronous stage IV colorectal cancer receiving combination chemotherapy without surgery as initial treatment. Presented at the 2009 annual meeting of the American Society of Clinical Oncology, May 29-June 2, 2009, Orlando, FL. Abstract CRA4030.


Charles

ADKer

HANRSC said:

Hello
In May underwent surgery to remove a small lung met. My normal CEA was around 2.14 and did not increase. After my surgery I received 2d opinion from another oncologist...he stated the CEA marker may or maynot increase because its reference marker is from the original Colon resection & MET to liver. In July 2009 I found that after consulting 3 oncologists prior to surgery that none told me about the study indicated below.

Colon Cancer News
http://patient.cancerconsultants.com/colon_cancer_news.aspx?DocumentId=43613#_ednref1

Surgery Unnecessary for Most Patients with Metastatic Colorectal Cancer
CancerConsultants.com - News 6/2/2009
Patients with newly diagnosed metastatic colorectal cancer do not need to undergo surgical removal of their tumor unless the tumor is causing complications, according to the results of a study presented at the 2009 Annual Meeting of the American Society of Clinical Oncology (ASCO) in Orlando, Florida.[1]
Colorectal cancer remains the second leading cause of cancer deaths in the United States. Metastatic colorectal cancer refers to cancer that has spread from the colon to distant sites in the body. Historically, standard treatment for metastatic colorectal cancer was removal of the primary tumor at the time of diagnosis. This was not to extend survival, but to prevent future complications that could be caused by the tumor.
However, many new chemotherapy drugs have proven effective in the treatment of metastatic colorectal cancer, and physicians have begun to speculate that surgical removal of the primary tumor is unnecessary and may carry more risk than benefit. Furthermore, immediate surgery often results in the delayed use of chemotherapy.
Researchers at Memorial Sloan-Kettering Cancer Center conducted a retrospective analysis of 233 consecutive patients diagnosed with metastatic colorectal cancer between 2000 and 2006 whose symptoms did not warrant immediate surgery. The patients were treated with one of three triple-drug regimens (FOLFOX, IFL, and FOLFIRI) with or without the addition of the targeted agent Avastin® (bevacizumab).
The results indicated that the majority of patients (93%) never developed complications that necessitated surgical removal of their tumor. The researchers concluded that most patients with metastatic colorectal cancer who receive immediate treatment with chemotherapy never require surgical removal of their tumor. They suggest that chemotherapy should be the standard of care for patients with metastatic colorectal cancer who do not have obstructed or bleeding colorectal tumors.
Reference:
[1] Poultsides GA, Servais EL, Saltz LB, et al. Outcome of primary tumor in patients with synchronous stage IV colorectal cancer receiving combination chemotherapy without surgery as initial treatment. Presented at the 2009 annual meeting of the American Society of Clinical Oncology, May 29-June 2, 2009, Orlando, FL. Abstract CRA4030.
Copyright Colon Cancer Information Center on CancerConsultants.com

Surgery Unnecessary for Most Patients with Metastatic Colorectal Cancer
CancerConsultants.com - News 6/2/2009
Patients with newly diagnosed metastatic colorectal cancer do not need to undergo surgical removal of their tumor unless the tumor is causing complications, according to the results of a study presented at the 2009 Annual Meeting of the American Society of Clinical Oncology (ASCO) in Orlando, Florida.[1]
Colorectal cancer remains the second leading cause of cancer deaths in the United States. Metastatic colorectal cancer refers to cancer that has spread from the colon to distant sites in the body. Historically, standard treatment for metastatic colorectal cancer was removal of the primary tumor at the time of diagnosis. This was not to extend survival, but to prevent future complications that could be caused by the tumor.
However, many new chemotherapy drugs have proven effective in the treatment of metastatic colorectal cancer, and physicians have begun to speculate that surgical removal of the primary tumor is unnecessary and may carry more risk than benefit. Furthermore, immediate surgery often results in the delayed use of chemotherapy.
Researchers at Memorial Sloan-Kettering Cancer Center conducted a retrospective analysis of 233 consecutive patients diagnosed with metastatic colorectal cancer between 2000 and 2006 whose symptoms did not warrant immediate surgery. The patients were treated with one of three triple-drug regimens (FOLFOX, IFL, and FOLFIRI) with or without the addition of the targeted agent Avastin® (bevacizumab).
The results indicated that the majority of patients (93%) never developed complications that necessitated surgical removal of their tumor. The researchers concluded that most patients with metastatic colorectal cancer who receive immediate treatment with chemotherapy never require surgical removal of their tumor. They suggest that chemotherapy should be the standard of care for patients with metastatic colorectal cancer who do not have obstructed or bleeding colorectal tumors.
Reference:
[1] Poultsides GA, Servais EL, Saltz LB, et al. Outcome of primary tumor in patients with synchronous stage IV colorectal cancer receiving combination chemotherapy without surgery as initial treatment. Presented at the 2009 annual meeting of the American Society of Clinical Oncology, May 29-June 2, 2009, Orlando, FL. Abstract CRA4030.


Charles

Concerns
As I read the summary of this study, I have to believe that the reason that the majority of patients never developed complications that necessitated surgical removal of their tumor is because they died before the complications could develop. As a patient who had quite advanced metastatic disease at diagnosis in February, 2008 and who now has teeny lung mets, CEA under 5, a great quality of life and a fighting chance, I am uncomfortable with anything that suggests that it is unnecessary to treat as aggressively as possible. I certainly have no expertise with which to challenge such a study. It just makes me uncomfortable and I hope it does not lead to less aggressive treatment of metastatic colorectal cancer patients.