Few questions

Buzzard
Buzzard Member Posts: 3,043 Member
edited March 2014 in Lung Cancer #1
Had CRC and now through an elevated CEA had a PET done and it shows a growth in lower left lung. Onc doesn't think it is metastisis from CRC but a primary...He is ordering CAT scan for later this week. Doesn't PET scan show miniscule cells and CAT shows more mass and less miniscule ?

I have been through CRC surgery, post op folfox (6 months) now after 2 years this comes up..
Any facts about what I may be looking at as in options,complete cure,chronic,chemo. I am just trying to gather as much info as possible so that in this whirlwind I have the right questions ready to ask. I am also pretty sure that Vanderbilt will be my primary treatment center.....Thanks in advance...I have been a member of the colorectal forum for almost 2 years now.....Buzz

Comments

  • soccerfreaks
    soccerfreaks Member Posts: 2,788 Member
    #2
    choices
    Buzz, when it got down to, um, acorn-cutting time, I would get both the PET and the CT. Like you, I think, I consider the PET to be more detailed, but, in any event, the important thing is to get more than one of whichever you are getting. One picture does not tell the story, while two over a few months can be held side by side to more reasonably define any growth.

    Ultimately, the one way I know of to get a more or less certain result is a biopsy. I happen to be a happy survivor of mis-read scans of both types, once told I had as little as 10 months to live, only to later find that what the docs were reading was really, for the most part, a lung infection. While you don't want to go around getting lung biopsies helter skelter (they hurt, frankly, and take lots of time in the hospital), you also do not want to predicate your future merely on the results of a scan.

    I have a feeling you know this, Buzz.

    With respect to options, I was fortunate in that the docs decided that the node that DID go to my lower right lung lobe was not mets but a new cancer of the same kind I'd had in my tongue/neck area. Ironic, sometimes, what we hope for, but that dx by them meant they would go ahead and do the lobectomy rather than letting the cancer live and, well, me not so much in short order.

    Many folks avoid surgery as being too invasive, but I am a big proponent of getting rid of it wherever it grows if the docs are up for it. I know a bunch of survivors who WISH they could have surgery but, unfortunately, cannot. If your cancer (if it is cancer) is confined to one lobe and is not mets, you may be a candidate for a lobectomy. If so, I would strongly consider it.

    Good luck going forward.

    Take care,

    Joe
  • Buzzard
    Buzzard Member Posts: 3,043 Member
    #3
    soccerfreaks said:

    choices
    Buzz, when it got down to, um, acorn-cutting time, I would get both the PET and the CT. Like you, I think, I consider the PET to be more detailed, but, in any event, the important thing is to get more than one of whichever you are getting. One picture does not tell the story, while two over a few months can be held side by side to more reasonably define any growth.

    Ultimately, the one way I know of to get a more or less certain result is a biopsy. I happen to be a happy survivor of mis-read scans of both types, once told I had as little as 10 months to live, only to later find that what the docs were reading was really, for the most part, a lung infection. While you don't want to go around getting lung biopsies helter skelter (they hurt, frankly, and take lots of time in the hospital), you also do not want to predicate your future merely on the results of a scan.

    I have a feeling you know this, Buzz.

    With respect to options, I was fortunate in that the docs decided that the node that DID go to my lower right lung lobe was not mets but a new cancer of the same kind I'd had in my tongue/neck area. Ironic, sometimes, what we hope for, but that dx by them meant they would go ahead and do the lobectomy rather than letting the cancer live and, well, me not so much in short order.

    Many folks avoid surgery as being too invasive, but I am a big proponent of getting rid of it wherever it grows if the docs are up for it. I know a bunch of survivors who WISH they could have surgery but, unfortunately, cannot. If your cancer (if it is cancer) is confined to one lobe and is not mets, you may be a candidate for a lobectomy. If so, I would strongly consider it.

    Good luck going forward.

    Take care,

    Joe

    Thanks Joe......
    I am in hopes that it is a primary and not mets. My Onc said he thought that getting it out asap was the best route...

    It seems that the PET showed 1 growth ...In you saying that if can be operable if not mets do you mean metastisis and if so why would the mets not be operable...or maybe I am flustered to much to calmly let it sink in....

    "If your cancer (if it is cancer) is confined to one lobe and is not mets, you may be a candidate for a lobectomy"......will you give a little more detail in why primary and mets are different in the way they are treated. Is it because the primary can be isolated in one spot and if detected early enough and no spread then elected surgery to rid of it completely would be the best route for complete removal. Mets would be that it would be in the bloodstream and that removal would be useless because of the areas that it could be and in that a maintenance chemo would be better to try and keep the mestastatic cells from spreading ?
  • soccerfreaks
    soccerfreaks Member Posts: 2,788 Member
    #4
    Buzzard said:

    Thanks Joe......
    I am in hopes that it is a primary and not mets. My Onc said he thought that getting it out asap was the best route...

    It seems that the PET showed 1 growth ...In you saying that if can be operable if not mets do you mean metastisis and if so why would the mets not be operable...or maybe I am flustered to much to calmly let it sink in....

    "If your cancer (if it is cancer) is confined to one lobe and is not mets, you may be a candidate for a lobectomy"......will you give a little more detail in why primary and mets are different in the way they are treated. Is it because the primary can be isolated in one spot and if detected early enough and no spread then elected surgery to rid of it completely would be the best route for complete removal. Mets would be that it would be in the bloodstream and that removal would be useless because of the areas that it could be and in that a maintenance chemo would be better to try and keep the mestastatic cells from spreading ?

    :)
    Yes. You nailed it. If it was mets, they would not operate precisely for the reasons you delineated. There is no telling where the little fellow went if it is mets, but if it is primary, they can confidently remove it and hope that the problem is gone.

    For me, to be honest, it results in a perpetual waiting game, as I am not sure it was mets since the type is the same. Still, it is worth it.

    I am here.

    Best wishes, my friend. Keep me posted and know that I am here if I can answer any of your questions, knowing beforehand that you are sadly an old pro at this yourself.

    Take care,

    Joe
  • Cheryl Z
    Cheryl Z Member Posts: 36
    #5
    Buzzard said:

    Thanks Joe......
    I am in hopes that it is a primary and not mets. My Onc said he thought that getting it out asap was the best route...

    It seems that the PET showed 1 growth ...In you saying that if can be operable if not mets do you mean metastisis and if so why would the mets not be operable...or maybe I am flustered to much to calmly let it sink in....

    "If your cancer (if it is cancer) is confined to one lobe and is not mets, you may be a candidate for a lobectomy"......will you give a little more detail in why primary and mets are different in the way they are treated. Is it because the primary can be isolated in one spot and if detected early enough and no spread then elected surgery to rid of it completely would be the best route for complete removal. Mets would be that it would be in the bloodstream and that removal would be useless because of the areas that it could be and in that a maintenance chemo would be better to try and keep the mestastatic cells from spreading ?

    Hi Buzzard
    You may remember
    Hi Buzzard
    You may remember me from the Colon Board. My husband had colon cancer last year also. Had surgery, chemo and radiation. Went for cat scan in December and they saw a spot on his lung. We decided to watch for 3 months until next scan. In March it grew a tiny bit and they were still not sure what it was. He went for pet scan and it did not light up so we decided to wait again. When he went in June the onc said he was not happy that it was even there. Being that they weren't sure what it was, he had a vats biopsy done 2 weeks ago. Test results came back Lung Cancer. Doctor said it is a Primary Cancer and not mets. He said that was better because if it was met from colon that meant it could have spread anywhere else and still not show up yet. With it being a primary, it is only in one spot so far so he is going in on Friday August 13th to have a complete right upper lobectomy.
    My husband Howie still has major issues from the colon cancer treatments. His neuropathy is still bad, he has hardly no feeling in his hands and feet. He has not driven in 1 1/2 years. He still needs to be near a bathroom at least 7 or 8 times a day. But at least he is still here. I just hope this next surgery goes well. Good luck to you also.
    Cheryl
  • Buzzard
    Buzzard Member Posts: 3,043 Member
    #6
    Cheryl Z said:

    Hi Buzzard
    You may remember
    Hi Buzzard
    You may remember me from the Colon Board. My husband had colon cancer last year also. Had surgery, chemo and radiation. Went for cat scan in December and they saw a spot on his lung. We decided to watch for 3 months until next scan. In March it grew a tiny bit and they were still not sure what it was. He went for pet scan and it did not light up so we decided to wait again. When he went in June the onc said he was not happy that it was even there. Being that they weren't sure what it was, he had a vats biopsy done 2 weeks ago. Test results came back Lung Cancer. Doctor said it is a Primary Cancer and not mets. He said that was better because if it was met from colon that meant it could have spread anywhere else and still not show up yet. With it being a primary, it is only in one spot so far so he is going in on Friday August 13th to have a complete right upper lobectomy.
    My husband Howie still has major issues from the colon cancer treatments. His neuropathy is still bad, he has hardly no feeling in his hands and feet. He has not driven in 1 1/2 years. He still needs to be near a bathroom at least 7 or 8 times a day. But at least he is still here. I just hope this next surgery goes well. Good luck to you also.
    Cheryl

    Thank you both..........
    I hope that your husband does well with the surgery Cheryl...Im sure he will. No matter how bad we feel its still good to be around...

    and Joe, thank you as well, I know that you are a warrior as well and yeah as bad as I hate to admit it I am becoming one. I did the CAT yesterday and should know something soon. It is what it is and I will deal with it good or bad...I am already compiling a list of calls mostly to Vanderbilt to get my itinerary together for the next run........I will keep you informed as I go , and again, thank you both......Buzz

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