Post Op Vats Surgery 4 week checkup........*****UPDATE*****

z said:

Clift
Hi Clift,

My question for my dr if it is a met to my lung, will be since I had no lymph node involvement, anal or lung, how did it travel via the blood stream and pick that spot in my lung to start growing, Is it because that was the easiest place to grow as the immune system couldn't get rid of it. I was a 35yr 1 pack a day smoker until 5-4-09, (days before start up of tx for anal cancer). I am anxious to learn of what the answers to your questions are. Lori

Buzzard said:

Jan...maybe a little better explanation
I had my first surgery 3/15/08 then did adjuvant Folfox for 6 months post surgery...I re occurred in July and had my 2nd surgery (VATS) in 09/07/10...I never had any scans during that 2 year hiatus until in July my CEA went from 2 to a 9.7 then after a second blood draw increased to a 10.4. Scans were then ordered, PET before CT (haven't figured that one out yet) and it confirmed a mass on the left upper lobe in the lingula area that did indeed path to be a CRC met . Then after my VATS surgery to remove 1/2 of the lobe the nodes that were taken out showed no sign of any cancer cells and all margins were clear, and there are no signs of cancer in any of my blood tests that were run. My guess is that there were a few CRC cancer cells that escaped and burrowed deep enough in the lung tissue to escape the barrage of chemo until the treatment regimen ended and then began the process of cell division until the mass was formed...My question is this, why did it get so large and wasn't detected until 1.4 cm size. Also , if it has no node involvement and all clear margins are clear that indicates to me that there is no way that it could be in my bloodstream now or the nodes somewhere would show activity coming or going in the lymphatic system, there is no indication of that either. I understand that cancer is a very tricky and deceptive disease, but I also understand that through all of this is a constant, that during my initial surgery in 2008 a lot of the nodes surrounding the area were damaged so severely that it wasn't a 100% that all nodes were clear even though the margins were so that tells me where the met cell came from, all now I have to worry about is when and where the next one that burrowed itself up during the initial barrage will rear itself and if a second chemo treatment regimen may be warranted and if so will it do any better than the first one did. I understand that the initial Folfox most likely killed a lot of stray cells and for that I am thankful, I am just wondering if a second one is necessary when I think a yearly regimen of scans would do just as good if not better than preventative chemo.....


In my opinion if my Onc were to tell me that a PET doesn't show anything of importance until it gets to be a certain size I would suggest 2 things, (1) to ask her again and see if she made the same statement...(2) if she did answer with the same outcome then I would tell her thanks but gotta go....

We have through discussion in here know for a fact that CEA is not a clear cut indicator for everyone...My tumor was 1.4 cm (about 3/4 ") before my CEA started to elevate so that negates that theory.....also a PET scan is a nuclear imaging scan that is designed to light up miniscule cells that feed faster than a normal cell would on a fructose(sugar based) imaging injectable liquid...A CAT scan shows more mass or tumor growths and then the PET scan shows the mass along with other miniscule cells of activity to show widespread, or specific locales of smaller cell activity in the system..They can then match the two to determine the best possible route to take in the treatment or removal of the tumor, growth, mass, or progression of the cancerous cells and to what extent they are invading...

QUOTE...."For some reason my onc seems to think that PET scans don't show anything of importance until met is at least 2 to 2.5cm." END QUOTE....
Thats approx 1 1/2" in diameter. I would think that a PET would most likely show it at its initial birthing.....and mets sometimes are very small nodules hidden by liver or lobe and not seen or found until the organ is actually manually manipulated and sometimes then others are found that weren't present when scanned or the scan missed it. I would gather a list of questions that were relative to your own treatment and health and ask away to see what type of answers I got and double check them with others. You need to trust your medical team 100%.....I will have several questions when I meet with my Onc the 12th of this month, one of which will be the reasoning for no scans at certain intervals, he will most likely tell me that my CEA didn't make a scan relevant, if he makes that statement then I will inform him that from now on scans will be relevant to assure that a 3/4" tumor doesn't get a headstart and a chance to invade nodes before it is detected. Yes Maam , I have a lot of questions to ask, and I will get answers....Buzz

traci43 said:

hope it went well
This post will likely get to you after the visit. Hope you got your questions answered and can think about how you want to proceed. I'll be interested to hear what the dr. had to say about post-surgery chemo. I've had 2 surgeries followed by chemo (FOLFOX) and have a third recurrance. Not looking forward to more chemo at all, but not willing to give up either. So I'm trying to find the balance there. I would suggest that you try another chemo, perhaps FOLFIRI. At least that doesn't have the awful neuropathy,but does have it's own side effects.
You are an inspiration to us on the board, and you are in my thoughts.