Test - soft tissue?

lp1964 said:

This is what I know.

X-ray can show cancer, but it's a flat picture so it doesn't show the exact location of the cancer in 3D.

CT is a 3 dimensional x-ray that shows exactly where the tumor is. It's often used with barium you drink to outline the tumor.

MRI is not an X-ray. It's a different energy. It's more accurate to show lesions.

PET scan is good to show where is cancer activity by measuring the sugar uptake of cells, but not good to show the outline of the tumor. It's mostly used to see if there are metastases anywhere, but for planning the treatment you need more accurate scans listed above. If used too early after surgery or radiation it often gives false positive activity, because cells that are trying to heal also show hyperactivity.

Ultrasonic scan also show cancer, often used right before and during surgery.

Now different doctors have different favorites and that's their personal choice. I believe you should have 2-3 doctors evaluate your scans especially at the beginning of your treatment.

Indurance companies also play games with this. They often try to conver on and not the other, because one can be much less expensive, but you or your doctor should never compromise on that.

if any of you have different info please, correct.

Laz

Laz,

Thanks for the note.  You're obviously well versed in the different technologies.  I've had 2 different oncology groups tell me basically the same thing, that as we go forward they would use the CT Scan and look to see if anything was spreading to hard tissue ie. liver, kidneys, etc.  If nothing is seen on hard tissue then we stay with the current treatment of Erbitux and ASSUME that the cancer is not getting worse.

Just seems with all the technological advancements that have been made over the years there would be some sort of test/scan that could pinpoint the cancer in the soft tissue and let us know if it's getting better or worse.  I guess it's just one of those things along the cancer journey that's a bit frustrating. 

Thanks again Laz for taking the time to drop me a note.  God Bless.

Ron

traci43 said:

PET, CT accurate for me at least

Ron - I hope that your treatment is effective.  It sounds like you've been through a lot.  I've had pretty good results with reduced doses and it can really improve the quality of life.

I have stage 4 colon cancer with mets to ovary and omentum originally.  First recurrance CT and PET showed 3 tumors near original site in pericolic fat.  I had HIPEC surgery and they only found those 3 tumors in a bit of omentum that was not removed during the first surgery.  The HIPEC surgery was 10 hours, and they went through my abdomen with a fine tooth comb. 

Recently I had a recurrance down by my rectum in the lymph nodes or fat.  It showed up on the CT and PET.  Now there may be many small mets that aren't visible to CT, PET or the surgeon, but generally CT and PET have been pretty accurate for me.  My HMO has then done separately.  What I've been told is the CT done with the PET is not as good at showing cancer as a stand-alone CT.  So I do CT scans until something shows up, then they use the PET to confirm that it's likely cancer.

 

Traci43,

Thank you for your note.  I guess the small bowel does present some challenges since it is alomost 20 feet long and all rolled up into a ball in the abdominal cavity.  Pretty tough for any test/technology to pinpoint something in that mess.

I appreciate your comment regarding the results you've had with 'reduced dose'.  Just had my 2nd reduced Erbitux treatment yesterday and it seems at this early stage that it has allowed me to feel better, thus improving my quality of life also.  I've continued to go to work through my entire journey so feeling the best I can is a huge deal.  I decided early on that giving up was not an option so I would force myself to get out of bed in the morning and get to work.  Some days I can only stay in the office till 1:00 or 2:00 and fortunatley my job allows me to be able to work from remote locations.  The skin rash from the Erbitux has been horrible in the past but seems much better with the reduced dose, and my fatigue factor is similar.  Hope things continue like they are - this is tolerable.

I also take comfort in your final comment about using the CT scans to find something, then taking further action.  That seems to be the course that I'm on  as well.

Thanks again Traci43 for taking time to write.  God Bless.

Ron

annalexandria said:

Welcome to the forum, Ron!

I too had tumors in the small intestine, and at one point, just as an experiment, my doctor had me do a CT scan, PET, and a peritoneal MRI (this is something fairly new, they had only done 12 of them at the large facility where I was being treated).  

The conclusion was that the PET was the best for showing that "something" was going on, with the caveat that it was not necessarily cancer.  Spots lit up on the PET on both the peritomeum and in the small intestine, while the CT showed nothing.  The MRI was a little more revealing than the CT, but not to the point where a radioloigst would read the results as cancer.

 I now get a combined CT/PET and it has shown every tumor I've had, even when they were fairly small (as in 1-2 cm).  At the same time, it showed spots that turned out not to be cancerous (apparently just normal bowel activity can sometimes result in a higher SUV).  My doc's approach has been to scan every three months, and if spots are seen that are iffy, to give it another three months, then scan again.  If there was change to indicate growth, then surgery was in order.

Just as an aside, I did a couple of different chemos, neither of which worked, but I was able to get to NED after my last surgery of five, in Dec. 2011, and have remained there since (knock on wood).

Good luck, and keep us posted on how things go for you.

Ann Alexandria

Hey Ann - Thanks for the info.  Interesting approach with the combined CT/PET tests.  I'll bring that up with my doc the next time we visit and see what she thinks.  It would sure be nice to know if things are getting better/worse/or staying the same.  Not only will I 'knock on wood' for you, I'll keep you in my prayers!  God Bless.

Ron