Confusing results
I had a pet scan on the 8th June which showed a spot on one of my lungs. My oncologist ordered a ct scan for the 17th June so a "work up could be performed" . The spot that was on the pet scan had disappeared on the ct scan.........but the ct scan showed there was another spot beneath the original that was 4.9 mils . The first spot was 5.9 mils.
Im a bit confused, how can there be this discrepancy in only one week. My oncologist says this happens all the time and can't give me a diffinative answer and has ordered another pet/cat scan for 6 weeks time. To me that's a long time to wait.
Comments
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It Does
Seem confusing. One spot is there then gone but another shows below it similar in size. These possibly could be one and the same. I know others have had scan discrepancies on here but that is usually due to getting a scan too soon after treatment and hot spots will give off false positives. I would think your doc would have a better explanation but it sounds like he has seen this before. I would say the 6-week wait is to make sure whatever is causing the anomalies gets settled out. If your treatment was considered a success I wouldn't worry much over this yet as your doc seems to be on top of it and also after my last episode they have discovered a small spot on my liver and lung. In all my treatments and scans this was never mentioned. These are small so I wonder if sometimes it depends on who's reading the scans. Also, I forget BUT how long has it been since you finished treatment?
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Lung Nodules
Hello Windmill,
The "spots" appearing in your imaging scans are lung Nodules. They can be caused by Infection, inflammation and other completely Benign causes.
I am Stage III Recurrent head/ neck SqCC, and right now I still have bilateral ( Double) bacterial Pneumonia. As I write this, I'm on 5 th floor Cancer Center hospital getting an infusion ..... Still have a fever, on Tylenol .... I hope to go home after this infusion.
Anyway, back to the lung nodules. When I was first diagnosed in 2017, I had several nodules in my lungs and at the time of course the fear was that my very large primary tumor had metastasized to my lungs. My primary tumor was 6.3 Centimeters by 3.1 Centimeters by 2.2 Centimeters thick, and that was my tongue, tonsils, floor of mouth, gums and into my bilateral salivary glands and mandible. Invasive monster tumor ( devil from he!!, ,). I also had Perineural Invasion. It was natural for us to expect the worst. ,( bilateral Neck dissection etc. See my profile)
However, they were only about 5 millimeters ( the lung nodules) and too small to biopsy .... I don't recall when my next scans were, at that time, but by the time I had more imaging they were gone, because I had Pneumonia then, from Aspiration and those lung nodules were bacterial collections, etc.
By now, I mean Right Now,--- I have my 6 th Pneumonia and this one is the second worst one I've had. I was released from 6 days inpatient/ went home on the 10th with a double lumen PICC line and I infused 12 more days at home IV antibiotics.... And now June 30, they Still hear Crackles and Rhonchi in my lung Bases, and middle Right lobe. These bases are tough to clear .... Now they want me on a daily antibiotic and additional stuff through my nebulizer.
Windmill, if these "spots" seen in imaging " come and go", then its not likely Malignancy, because as all of us here can tell you, tumors don't come and go. Benign things might but not cancer..
So, if I were you I wouldn't be focused on/ worried about it. And your next scans should better reveal what its about. Hopefully just transient inflammation, etc.
My last Chest CT was so Abnormal, that they ordered a Bronchoscopy with BAL. They looked Worse than COVID lungs, they said and in fact they did test the Inside of my lungs for every Virus known. Its a really long list !!! I had tree-in-bud pattern throughout plus ground glass opacities, and they were panicking because they suspected Atypical infection ( MAC, for instance). Which takes 6 months to a Year to treat.
What they found thus far, was bacterial pneumonia. Red, inflamed lungs with sticky mucoid secretions throughout....etc. I am still on restricted activity.
Okay my infusion should be over by 4:30 today, and then I can go home. I think.
I hope I eased your mind about the nature of 90 something % of all lung nodules. They usually clear on their own.
Unless they are like my "Persistent nodular opacities"..... Clouding up my lungs.... This pneumonia has to go away eventually.... Right?
LitlCJdoll
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I finished treatment at the
I finished treatment at the end of January 2021. I was T3 N2 Mo BOT scc. I was admitted twice during my treatment, that chemo really messed me up. I had to have a blood transfusion with the first admission. But I didn't miss a treatment no matter how sick I was.
My post treatment pet scan showed a hot spot where the primary was so I had another pet scan 6 weeks later. This one showed the hot spot gone and the first spot on my lung. Then the wheel started to turn.
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You Are
Actually not that long out of treatment give it time and take comfort that your Oncologist is right on top of it and is watching closely and ordering scans. And I think Crystal had some great input to this and she is very knowledgeable and unfortunately has had some first-hand experience but as she says over 90% of lung nodules usually clear up on their own. Hope these inputs are helping you. If you had a PET scan before treatment which you should have had to make sure cancer was nowhere else in the body and it didn't show anything and they treated your cancer area then it's gone don't worry when you are fresh out of treatment at least that's the way I looked at it. If any cancer worries were in my mind it was the what if's a couple of years out but I never dwelled on it and we can't, just enjoy the day, every day and savor them and enjoy the gift of life cancer treatment today gives us and like we say on here NEGU (Never Ever Give up) Take Care-God Bless-Russ
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Thank you!wbcgaruss said:You Are
Actually not that long out of treatment give it time and take comfort that your Oncologist is right on top of it and is watching closely and ordering scans. And I think Crystal had some great input to this and she is very knowledgeable and unfortunately has had some first-hand experience but as she says over 90% of lung nodules usually clear up on their own. Hope these inputs are helping you. If you had a PET scan before treatment which you should have had to make sure cancer was nowhere else in the body and it didn't show anything and they treated your cancer area then it's gone don't worry when you are fresh out of treatment at least that's the way I looked at it. If any cancer worries were in my mind it was the what if's a couple of years out but I never dwelled on it and we can't, just enjoy the day, every day and savor them and enjoy the gift of life cancer treatment today gives us and like we say on here NEGU (Never Ever Give up) Take Care-God Bless-Russ
Thank you, Russ As is usual, you know quality and experience when you see it. LOL!!
Yes, it's unfortunately true that with 6, count 'em, 6 Pneuminias.... Pneumoniae with a Collapsed lung twice, Pneumonia with Sepsis secondary to the pneumonia, Double pneumonia. ... Etc.
Now, I have irreversible Permanent damage= Bronchiectasis . You may have to look it up. It's not common. It's actually worse than COPD. Add to it my Primary ( genetic) Immunodeficiency, and it's a recipe for early death from respiratory failure. My doctors have a massive challenge with me. The Immunodeficiency complicates everything else. My head & Neck oncology surgeon told me that it enables my SqCC tumors to act more aggressively and to keep recurring.
he said he has Organ Transplant recipients who acquire this cancer, and he said because they take immunosuppressive drugs to maintain their transplanted irgan, he said they are in the same boat I am. That the compromised immune system enables this cancer to run rampant .
Yes, I realize I'm way off topic, for this question. But just trying to illustrate that I know lung problems and that I had the same experience, wondering about several lung nodules they found in me.
Heck, I also have 2 masses/ lesions on my Spleen. We have never biopsied then and they are plenty large enough. However, in 3 years they've not grown. Hmmmm, it couldn't be My cancer then, because my 6 tumors this far, showed definite Growth!!
So, whatever is on my Spleen... It's okay for now.
What about the large one beside my right vocal cords?? It's in Moderate Dysplasia meaning it's Pre Malignant. Well, he has zapped it with laser surgery, and it comes back...
Russ, it is 100% Accurate that it's best not to dwell on things we cannot affect, at the moment. Just let those things float on by. I mean, you know they are there, but just observe... Don't dwell on it. Free up your mind for other things you can more immediately change and work toward.
I spent all day in the Cancer Center hospital getting an infusion. ( my poor veins have taken a beating this month) All I could think of was Randal. And how I wish I could talk to him and see him once more. His 60 th birthday was February 11th. He left much too soon, but with 2 different Stage IV cancers, he fought for 9 long years. He was all about The Fight.
he's finally in peace.
Crystal
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Similar Experience
I finished radiation treatment for stage 3 tonsil cancer 6 1/2 years ago. The first pet scan post-treatment showed residual cancer at the same spot in my neck and a small spot on my long. My oncologist suspected residual scar tissue due to treatment and recommended a follow-up scan in 6 months. I have had clear scans ever since.
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Great example!armana said:Similar Experience
I finished radiation treatment for stage 3 tonsil cancer 6 1/2 years ago. The first pet scan post-treatment showed residual cancer at the same spot in my neck and a small spot on my long. My oncologist suspected residual scar tissue due to treatment and recommended a follow-up scan in 6 months. I have had clear scans ever since.
That's great news, Amana and a great example too. It seems like our lungs can get " dirtied up" with stuff at times when out illness is at its height and then it might resolve and clear up, as other issues clear as well....
Good to hear!
Crystal
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I have four of themLitlCJdoll said:Great example!
That's great news, Amana and a great example too. It seems like our lungs can get " dirtied up" with stuff at times when out illness is at its height and then it might resolve and clear up, as other issues clear as well....
Good to hear!
Crystal
Lung nodules are fairly commom. Dont fret over them. I forget the math but if you randomly screened people off a bus a bunch would have lung nodules for various reasons. In the midwest it's caused by infection from bird droppings. My nodules have been there now for over ten years and I wasted a bunch of time worring about them. Never changed much, although they can change a little bit and even that is no cause for worry because it depends how the scan beam is cutting accross them, they tend to be peanut shape, so if the beam cuts the peanut in the center they will be smaller and if in your next scan they cut across the edge, a little bigger, hang in there, chances are you just got off the bus in probability mode.
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Lung infectionsratface said:I have four of them
Lung nodules are fairly commom. Dont fret over them. I forget the math but if you randomly screened people off a bus a bunch would have lung nodules for various reasons. In the midwest it's caused by infection from bird droppings. My nodules have been there now for over ten years and I wasted a bunch of time worring about them. Never changed much, although they can change a little bit and even that is no cause for worry because it depends how the scan beam is cutting accross them, they tend to be peanut shape, so if the beam cuts the peanut in the center they will be smaller and if in your next scan they cut across the edge, a little bigger, hang in there, chances are you just got off the bus in probability mode.
Hello R F,
In reference to the lung problem connected to hire droppings, I will bet its MAC you are describing . Mycobacterium Avium Complex. I
Correct me if I am wrong.
At any rate, that specific infection causes way more damage than just lung nodules. It's an infection they evaluated me for in May through June because of my DR and x ray results. Usually, it's treated with 4 different antibiotics at once over a period of 6 months to a year...!! It's not good at all! It can be caused by other sources too, not just from birds.
Let's hope any lung nodules are the more common, transient and benign types..
LitlCJdoll
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Update
It will be 3 months on the 8th September that the pet/ct scan identified a spot on my lung that was 5.9 mil. After a few more scans and as from the 4th August it has grown by 1.1 mil. My oncologist discussed this at a MDT meeting and it was decided to refer this to the lung MDT meeting. The general consensus at the lung meeting was that it was a met but seeing it is too small to biopsy referred me to have a bronchoscopy to see if it's an infection. That was 2 weeks ago and the respiratory doctor called me yesterday. The scope couldn't get to where to spot was on the ct scan so they performed a wash. The wash was collected and this showed that there was no infection however it will take another 6 weeks for other results to be known.
I called my medical oncologist yesterday and he advised that it's too small to biopsy, they have to wait for these other results in 6 weeks and really can't treat it yet as it may not be cancer but they think that it is. He reassured me that if they thought it needed treatment that would have been done and that at the moment it's safe to wait the 6 weeks. So I suppose it will be another scan if these results aren't conclusive or not. This waiting and not knowing is a concern but I'm taking it one day at a time.
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Broncoscopy and the 6 weeks wait
Hello Windmill,
Yes, I experienced the same experience -- May 13th was my Broncos copy with BAL (the saline Lung Lavage " washing".
To clarify, right now, my lungs have infections. No malignancy found.
What they found in mine was " diffusely erythematous" tissue (the entire lung was red and inflamed) and thick Mucoid secretions throughout. The saline mixture is sent to the Lab for Multiple tests and yes, some of them take 6 weeks, like the MAC infection I described here in this thread. They also check for all Viral infections, and Tuberculosis, etc.
Because my CT was so abnormal, they were fearful for MAC, in me. Or COVID. THE CT was really bad. My CT was done without contrast, ...
Anyway, what they found in mine was permanent, irreversible damage from Bronchiectasis, and like adult onset Cystic Fibrosis.
And the Washing solution cultured out E. Coli, and its a Drug Resistant form, which explains why the antibiotics taken at home did nothing.
By June 4 I was admitted to the Cancer Center Hospital with my 5 th pneumonia. Bilateral bacterial pneumonia. It was in both lungs.
I'm still not clear and awaiting results of a Pulmonary Lung Function test which I took Wednesday this week.
Now, I realize you are talking about potentially Malignant nodules.
The measurement you gave of the nodule is quite small and I guess too small for biopsy.
When my Nodules were 5 millimeters they were too small,
They Do Not Know if its a met, or from something completely different. Something that small has no effect. Is it just that one?
Most every time something is that small, even if cancer---+++ they just Watch it.
Its another case of Risk versus Benefit. In other words, why risk a lung biopsy, where something can go wrong like collapsed lung ( I have had 2 instances of that, in right lung), when the lesion is too small to take that chance on.. No benefit to taking it out, at that size.
I know its hard not knowing but you have had Scans, and you've had a direct Bronchoscopy . They have checked it out very well.
So, just try to be patient and wait for the Bronch tests to come back.
And on that note, its time for me to do another breathing treatment through my Jet Nebulizer.
HNSCC created in me this whole scenario, in which I Aspirate my oral intake ( all liquids), and my Anesthesiologist told me last week that even if I go NPO, and quit all oral intake, that I will still aspirate my saliva, and reflux. She said I will aspirate no matter what. So, do I keep drowning myself by drinking liquids, or stop? Does not matter because its gonna keep happening. 5 pneumonia so far, all admissions.
I am really sorry you are faced with this possibility of another site being involved, but take a Deep Breath, and try to keep occupied with other more pleasant thoughts and activities. I have tried to do that because I am still going through admissions ( admitted twice, In June and in August ) and never ending appointments and procedures.
Wishing you some enjoyment in our long weekend.!
Crystal
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I Have A NoduleWindmill said:Update
It will be 3 months on the 8th September that the pet/ct scan identified a spot on my lung that was 5.9 mil. After a few more scans and as from the 4th August it has grown by 1.1 mil. My oncologist discussed this at a MDT meeting and it was decided to refer this to the lung MDT meeting. The general consensus at the lung meeting was that it was a met but seeing it is too small to biopsy referred me to have a bronchoscopy to see if it's an infection. That was 2 weeks ago and the respiratory doctor called me yesterday. The scope couldn't get to where to spot was on the ct scan so they performed a wash. The wash was collected and this showed that there was no infection however it will take another 6 weeks for other results to be known.
I called my medical oncologist yesterday and he advised that it's too small to biopsy, they have to wait for these other results in 6 weeks and really can't treat it yet as it may not be cancer but they think that it is. He reassured me that if they thought it needed treatment that would have been done and that at the moment it's safe to wait the 6 weeks. So I suppose it will be another scan if these results aren't conclusive or not. This waiting and not knowing is a concern but I'm taking it one day at a time.
As they call it on my lung that is small and just watched during my regular scans.
The spot on your lung must be small if they can't biopsy it.
I converted it at an online converter to inches am I right that the spot is 9/32 of an inch.
Many on here have nodules or unusual things that the docs are watching for growth.
This may help.My sister had a spot on her lung and it was cancer.
They watched it for a number of years and it stayed the same.
She had an X-ray or cat scan-not sure which to monitor it every year.
Finally, it started growing so they set her up with the Cyber-knife and it has eradicated the cancer
spot, it is no more and she is clear of cancer.So make sure and ask them about the cyber-knife.
If it turns out to be cancer it is more of a concern for sure.
And better yet if it needs something done the Proton therapy I think is even better
as it causes much less damage to surrounding tissue if there is one near you.
They are very expensive machines and there are only so many in the United States.
This article states-
While there are currently only 22 proton therapy centers in the United States, the growing interest in advanced cancer therapy is causing more hospitals to weigh the benefits against the high cost of opening their own centers.At one time a proton center once cost between $120 and $200 million, new refinements in the existing technology are lowering costs at a time when more cancer patients are looking for this treatment option.
"The cost has come down substantially from what it was a decade ago," said Metz. "It used to be at least $100 million for an entry point. Now it's $30, $40 million. A lot of players didn't have the financial ability to get into the game at the time."
Article https://www.healthcarefinancenews.com/news/proton-therapy-tech-become-cheaper-more-hospitals-look-add-centersIs Proton Therapy Safer than Traditional Radiation?
National Cancer Institute
Wishing You The Best-Take Care-God Bless-Russ
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Its difficult, I knowWindmill said:Thanks Crystal for your
Thanks Crystal for your reassuring words, so far all my scans have only shown one spot so i hope it remains so. One day at a time.
Dear Windmill,
? I don't know if I came across as reassuring, .. However, i do know how difficult this road is. Dear, my own cancer has come hack 5 times, and even a fast growing and Invasive tumor 9 months after my radiation treatments. Surgeries upon surgeries.... One of my doctors tried Injectable Methotrexate directly into a tumor, trying to spar me more surgeries..Ouch !!!!. Etc. Very painful, dropped my blood counts further and did not work.
But I was in the groove of going along with anything. Try something, please ?!
I have gone through a lot. Its been a Fight for me the entire way, I cannot sugar coat it. I came back from 64 pounds and 7+ hours of surgery, Glossectomy, etc. Only for it to come hack 4 months later. 5 surgeries that first year.
I cannot tell you exactly how to Cope. I guess everyone has their own way. In my life, I use humor , and I've developed a hardened, devil -may care attitude at times, too.. And then other times, I've been Angry and wanted to Fight hard. I have cycled through all that and then Grief, heartbreak and Loss this May , , losing someone very close, to this same cancer, ---then having to fight hard for myself by myself in the hospital twice.
So, I am tired, feeling beat up at 71 pounds. However, " something" gets me up every morning, to get ready to start again and do the work of that day, no matter what it turns out to bring to me. I have not yet given up.
You have Strength, in yourself and I can feel it through your writing.
Thank you for coming here to tell us all that's going on. We get through better, together.
Crystal
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I have been waiting patiently
I have been waiting patiently for 6 weeks to get the results of my bronchoscopy wash. I had a phone consultation with the Respiratory doctor last Thursday. No one rang. I had to wait until I saw my oncologist yesterday (Thursday) one week after the non phone call. Very poor. Anyway I'm now going to have another pet/ct scan in the next three weeks to see what's going on. My last scan was on the 4th August. On we roll.?
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Good follow ups
Hi again,
You posted that message above on my birthday. Now its Halloween night and I'm still in the hospital. And yes, its been kind of wild on this 8 th Floor, tonight. Some funny / creepy stuff/ goings on!
H ey, I am glad they are following up with another PET. You posted that one 10 days ago, so that PET is in mid November, or earlier? Good. I think that's good turn around time. Not stuck for months more waiting.
I wish you the Best and please let me know, what results are shown and next moves if any.
Hey, maybe the nodule won't even be there...and no malignancy! Keep hope !
Crystal
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G'day Crystal, happy belated
G'day Crystal, happy belated birthday and glad to see you haven't dropped off the end. A few people here were worried about you. Yep I'll have the Pet on the 10th November and my oncologist will ring me on the 11th. It's a 3 and a half hour drive to the hospital so 7 hours driving and at least 2 hours for the pet, it's going to be a long day.
On the 4th November it will be 5 months since the pet scan found the nodule and 3 months since my last pet scan, I think we will know for sure this time.0 -
3 and 1/2 hour drive..
Oh dear, I feel so lucky because I am 3.1 Miles from this big Comprehensive Cancer Center/ Teaching Hospital/ School of Medicine / Trauma Center/ Brenners Children's Hospital . I am here so often...
If healthy I could Walk here easily, but I have pneumonia right now and today 70.6 pounds .
I hope you have someone to tag along with you for that long ride..
I like your stoic and matter of fact attitude. That's how I do it and taking stuff day by day. Like " I am going to do what needs doing right now, and whatever is next, I can't control it so just let it be. I will face it when it gets here.
Because at times, like now, there's plenty enough trouble/ things to do/ stuff to get through----- and really there's no room for whatever isn't even here yet.
I'm not sure I'm making any sense, in my weakened state ?
No let up at all in these antibiotics. Days and days of around the clock. Not one word yet about discharging me...
Day by day, right?
Please keep us posted.
Crystal
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My oncologist rang me
My oncologist rang me yesterday arvo with the result from my pet/ct scan. Good news no Mets anywhere after 5 months but that spot that was seen back then is still there. It has grown to 1.5 cm since my last scan on th 4th August, that's 7 mils. He said he thinks it's a another primary cancer as this one has grown tentacles. So I'm off to have a biopsy in the next week or so. Apparently it was too small in August.
i had prostate cancer in early 2018, had prostate removed and 6 months later my psa started to rise again. 33 treatmenets of radiation and so far no psa. Then had this hpv opc and now a new primary. I'm loved. ?0 -
I hate it
Oh gosh,... I am in middle of infusing intravenously through my PICC line ( and I just broke sterile field so I can write you)-- This is so upsetting.. Tragic, and terrible and there really no words to describe it all. Damn.
And you have to wait for Biopsy, and then 3- 7 days for the Pathology report .
Sorry, this does make me tear up, that another of us has to go through it all.
Having had 5 Recurrences and a New Primary after my radiation treatments---- well, I can say I do know exactly what its like going through it all.
Of course, you do not know for sure till you get that Path report ( I've got a stack of those, too) but the fact that it's grown , etc. Is really concerning.
I am sure that others here who have had multiple cancers, recurrences, or Mets will write you and give their Helpful words and support.
To me, the words are never enough and I'm always left thinking to myself, Gosh, I want to Do something to make all this just stop !!!!!
?
Thinking of you. I hope your family is very supportive and helpful....
Stay strong !!!
Crystal
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