Friday's CT-Scan 'official' results & pre-treatment mtg. today with radiation oncologist

lindaprocopio said:

Not sure I'm 'dancing' right now, as that lung nodule is scary.
The thing is, a CT scan can't really show anything smaller than 1 centimeter, which is why my radiation oncologist was a bit angry that they would even flag something as small as 2.7 mm. He said that noting something like that on a CT-scan just worried a patient (so true!) and is something an oncologist has no way of confirming (too small to warrant a PET-scan; way too small to find surgically). It only 'appeared' on 1 slide, it is that small, and he showed me a bunch of slides where other normal marks looked just as big and just the same, and said that I should totally put this out of my mind, that he believes this is nothing and a 'CYA' (Cover Your As$) in case something shows up later and they can say they flagged it.

I believe him that this is nothing. But it does kind of ruin the long happy 3-month "dance with NED" I was hoping to enjoy until my next CT-scan in July. It will be harder to have them radiating my pelvis and vagina, wishing I were back in chemo attacking that probably-non-existant nodule in my lung. I may have to call my chemo oncologist to talk about this and then hopefully I can really not worry.

lindaprocopio said:

Not sure I'm 'dancing' right now, as that lung nodule is scary.
The thing is, a CT scan can't really show anything smaller than 1 centimeter, which is why my radiation oncologist was a bit angry that they would even flag something as small as 2.7 mm. He said that noting something like that on a CT-scan just worried a patient (so true!) and is something an oncologist has no way of confirming (too small to warrant a PET-scan; way too small to find surgically). It only 'appeared' on 1 slide, it is that small, and he showed me a bunch of slides where other normal marks looked just as big and just the same, and said that I should totally put this out of my mind, that he believes this is nothing and a 'CYA' (Cover Your As$) in case something shows up later and they can say they flagged it.

I believe him that this is nothing. But it does kind of ruin the long happy 3-month "dance with NED" I was hoping to enjoy until my next CT-scan in July. It will be harder to have them radiating my pelvis and vagina, wishing I were back in chemo attacking that probably-non-existant nodule in my lung. I may have to call my chemo oncologist to talk about this and then hopefully I can really not worry.

lindaprocopio said:

I've had 3 diagnostic CT-scans so far; 1st two were NED.
This is my 3rd CT-scan and so they had the first 2 to compare this one to. My daughter-in-law, a CT-technician, said all of my 3 CT-scans look exactly the same and I mustn't worry. Even so, I phoned my chemo oncologist today, just in case he wanted to postpone the radiation and try and get in a couple more rounds of chemo in light of this new scan. He said no, that he also disregards a 'finding' in the millimeter size and is comfortable with us sticking to our origibal plan of starting pelvic radiation next. I get my next CT-scan in July, and he is okay with that. So I have my 2 oncologists both 'pooh-poohing' the 'finding' as insignificant. I will try and think of it that way also, as long as July's CT-scan is NED! (We'll see how good I do with this "not worrying" in the dead of night!)

I had a bank board meeting this morning and the bank president, who lives in the same swanky housing development as many of these doctors (and is close friends with my radiation oncologist), offered to make a call and have someone else look at my scan again for another opinion. He said he's done that for others and seemed pretty confident that he could make that happen. That would be nice, if he has that kind of pull.

bonniesue said:

IMRT vs 4 beam
Linda, It is amazing that you could find the info regarding these two different forms because I had my mom to two different Rad. oncs and one said maybe on her back and the other maybe on her stomach. One mentioned IGRT and doing four beam, the other IMRT. NO wonder the confusion as I wish it was more cut and dry. I have turned into a google nut and I really am no fan of computers..You are in my thoughts and prayers. bonniesue

lindaprocopio said:

I'll be getting IMRT for my external pelvic radiation.
Thanks for this new information on IMRT, Janet, as that is what I will be having for my external pelvic radiation. I get the feeling IMRT is pretty standard at Geisinger (where I go.) My radiation oncologist made the '4-beam' I was asking about sound like it was a "10 years ago" technology, and I felt a little foolish to be so out of date in my research and in all of my side-effect worries I had listed to discuss. I had my simulation CT on Friday and there was no discussion as to any other possible radiation technique they might use. He did say that they would have no trouble being able to avoid my small bowel without a shield, and even reassured me that they would stay away from my bones to protect my bone marrow. I don't see how 'pin-pointed' they can be, when I have no evidence of disease in my pelvic region, and so I can't figure out what they are actually 'aiming' at. I assumed it would be a broad sweep. I guess I have more questions to ask when I go April 30th for my 1st radiation treatment.

nursey420 said:

bonniesue
I go to Maplewood cancer center in Maplewood MN. It is IMRT treatment and I lay on my stomach I have a tatto (blue dots) on each hip and one on my left butt check plan on making them smiley faces after treatment is over. The radiation techs line me up by the hip dots and then the butt dot. No CT in the machine but they take x-rays mon weds and fri to make sure the beams are going to the right area. I had a CT done before treatment with vaginal marker started and then a CT with PET a few days later. I have 7 differant beam locations during each treatment and all 7 are shot twice. My Radation doctor beleives that laying on one stomach drops the bowels out of the way and full ballder pushes it up. I spoke to several professionals( am a nurse) about treatment and beleive i am being seen by th best in my area. I have has some loose bowel and cramping but nothing to bad. Best way to find a good place is to talk to your oncoligist. Lisa

lindaprocopio said:

Where I go, the CT scan is built into the IMRT radiation gizmo
All I've had is my simulation (actual radiation to start 4/30), but the CT-scan was built into the IMRT. I was on my back on a hard flat surface. (They said it was important that the surface had no 'give', for positioning.) There was a padded vinyl leg support that went under my bent knees and I had a little free-floating padded ring I was to hold onto with both hands on my chest, bent arms, elbows at my sides, (to help me hold still I think.) It really wasn't uncomfortable. I went into the CT-scan ring head first, different than my regular CT-scans. I had a 'vaginal marker' inserted that was just a small narrow rod to mark the top of my vaginal cuff. They made the 3 tiny tatoos with only a couple of small almost painless sticks in each hip and the very center of my pelvic bone, down pretty low, all in a straight line. When I asked about being on my stomach or back, the radiation oncologist said that with IMRT they automatically worked around the small bowel and bones, etc., and so a 'belly-board' (for stomach down radiation) wasn't necessary, and that I would be on my back; nor did he seem concerned that I have a full bladder or not, although I think I'll do that anyway as a precaution unless they tell me to go pee first.