Does activity on the petscan always mean the cancer is back?

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brigboo67
brigboo67 Member Posts: 24
in Head and Neck Cancer #1
My mom had HP+ BOT cancer that had spread to lymph nodes in both sides of her neck. She had 35 rad treatments with 3 cisplatin. The first petscan post treatment showed NED. However, yesterday she had her second Petscan and it showed activity at the site of the original tongue tumor and two small lymph nodes in the thoracic area showed activity. I asked the dr if it could be just inflamation and she said she doesn't think so. Has anyone else had this happen and it not be cancer?

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  • Hal61
    Hal61 Member Posts: 655
    #2
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    Times?
    Hi Brigboo, you haven't mentioned the time spread on the scans. It's more normal to have activity caused from inflamation at like, 3 months, but it can show at 6. I don't know about the activity at the original site, or what the "radiance" reading was, but a partial neck dissection of the treatment that often follows chemo, and rads to clean up activity in lymph nodes. I would get a second opinion, and maybe another scan, and have the amount of activity clarified. I had 15 lymph nodes removed in a partial dissection, and two were positive. Been clear since and I'm approaching two years out.

    best, Hal
  • brigboo67
    brigboo67 Member Posts: 24
    #3
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    Hal61 said:

    Times?
    Hi Brigboo, you haven't mentioned the time spread on the scans. It's more normal to have activity caused from inflamation at like, 3 months, but it can show at 6. I don't know about the activity at the original site, or what the "radiance" reading was, but a partial neck dissection of the treatment that often follows chemo, and rads to clean up activity in lymph nodes. I would get a second opinion, and maybe another scan, and have the amount of activity clarified. I had 15 lymph nodes removed in a partial dissection, and two were positive. Been clear since and I'm approaching two years out.

    best, Hal

    Times
    Thanks for responding Hal61. The first petscan was 6 weeks post treatment and the petscan yesterday was 4 1/2 months post treatment. The dr said that the activity level was a 6 which makes her think it is cancer and not inflamation. The ENT oncologist didn't think the neck disection was necessary since the first pet scan showed NED in the neck nodes and she had responded so well to treatment. These nodes are in the upper chest area that are hot spots now.
  • NJR
    NJR Member Posts: 82
    #4
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    brigboo67 said:

    Times
    Thanks for responding Hal61. The first petscan was 6 weeks post treatment and the petscan yesterday was 4 1/2 months post treatment. The dr said that the activity level was a 6 which makes her think it is cancer and not inflamation. The ENT oncologist didn't think the neck disection was necessary since the first pet scan showed NED in the neck nodes and she had responded so well to treatment. These nodes are in the upper chest area that are hot spots now.

    So sorry to hear
    PET Scans are not infallible as I am sure you know their primary value is the isotopes are absorbed very quickly by the highly metabolic cancer tumors. Certain viruses and bacteria however also have this characteristic and can signal a false positive. Also, extreme exercise or physical exhaustion as much as 48 hours before a PET Scan can can appear as a malignant tumor.
    I had a questionnaire to fill out that addressed these issues and lab work before the scan that I assume would have ruled these possibilities out. I have personally never met anyone who had a false positive on a PET Scan but if in doubt you might ask if they will do it again.
  • Hal61
    Hal61 Member Posts: 655
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    brigboo67 said:

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    Thanks for responding Hal61. The first petscan was 6 weeks post treatment and the petscan yesterday was 4 1/2 months post treatment. The dr said that the activity level was a 6 which makes her think it is cancer and not inflamation. The ENT oncologist didn't think the neck disection was necessary since the first pet scan showed NED in the neck nodes and she had responded so well to treatment. These nodes are in the upper chest area that are hot spots now.

    Time and numbers
    Hi Brigboo, the first petscan can pretty much be thrown out--too soon-- but you said it was clean. Unfortunately, the doc has reason for concern. 6 is enough the overr the 3.5 (I think, maybe it's 3), that's borderline to cause concern. If the activity in the upperchest is indeed lymph nodes, then there are a few avenues of treatment, and the fight back to health is certainly still possible. Secondary chemo with Erbutex, removal of troublesome nodes. I'm not doc, but even if she has a recurrance, if the spread is not to the lungs themselves that's good. Keep your fingers crossed and know there is still treatment that has shown to be effective if the stubborn cells are still present.

    Best to you and your mom, Hal
  • soccerfreaks
    soccerfreaks Member Posts: 2,788 Member
    #6
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    Take no chances, but...
    I am a survivor of both head/neck and lung cancer. A scan in June of 07 indicated a massive return of cancer from the original head/neck to both of my lungs. I was told I had as little as 10 months to live.

    I was scheduled for a subsequent scan for some time in August. I guess to establish its rate of growth. In the meantime, I was taking keflex for an infection in my face. When I got the ssecond scan, all of the 'spots' were gone, with the exception of one, which proved to be malignant. It turns out the Keflex killed the 'spots' that turned out to have been a lung infection.Following a lobectomy and chemotherapy, I am now 6+ year clear of head/neck and nearly 4 years NED for the lung (from time of surgery).

    So, yes, it happens. It is probably rare, but it happens, as it did to me. Others have given some fine examples of other situations that may also occur.

    Best wishes to mom and her family.

    Take care,

    Joe

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