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What does a CT show

AndyE
Posts: 51
Joined: Nov 2014

I had a clean chest CT last week, so apparently the 4.5 cm tumor on my kidney hadn't spread to my chest.  I have, however, noticed for a few weeks now some strange pain below my right nipple as well as a feeling that my mid back is "out."  Does anyone know if the chest CT would have shown mets on my spine or ribs?  Of course I am still paranoid that this has spread.  Are bone Mets usually able to be treated successfully?

APny's picture
APny
Posts: 1987
Joined: Mar 2014

For bone mets I think you would need a bone scan. A chest CT would not show mets to the best of my knowledge. I really doubt a 4.5 cm tumor would have gone to your bones already but I absolutely get the worries. Any ache and pain is immediately related to our cancer, unfortunately. I do the same thing. Talk to your doctor; maybe s/he could put your mind at ease or order a scan to put your mind at ease.

sblairc's picture
sblairc
Posts: 586
Joined: Feb 2014

I think CT's do pick up some bone related information, but I'm not sure to what extent. Good question. I know a nuclear bone scan is usually not given unless clinically indicated, not a standard scan for suspected renal cancer unless they have reason to think you have metastitic disease in your bones or are a high stage/grade. I don't think a 4.5 tumor would warrant it at this point. 

Interestingly enough, my husband's urologist gave him one post-op to get a "baseline" with a Stage 3 tumor. I've since read it wasn't totally necessary but I was really happy he had one. 

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Jojo61
Posts: 1310
Joined: Oct 2013

I was also a Stage 3 tumor with radical nephrectomy last December. All I have ever had done since is bloodwork and 2 CT Scans. Should I be having a bone scan? Or any other scan? I am unsure, which post-op baseline test your husband had?

Thanks for your info. I am always learning.

Hugs

Jojo

sblairc's picture
sblairc
Posts: 586
Joined: Feb 2014

duplicate

sblairc's picture
sblairc
Posts: 586
Joined: Feb 2014

I found out afterwards, he didn' t really medically need the bone scan. The American Urological Association has a website with a lot of information about follow up care for Renal Cell carcinoma, and I read the following: 

Guideline Statement 4: The Panel recommends a bone scan in patients with an elevated alkaline phosphatase (ALP), clinical symptoms such as bone pain, and/or if radiographic findings are suggestive of a bony neoplasm. (Recommendation; Evidence Strength: Grade C)

Discussion: Studies that address the utility of an initial bone scan in the work up of patients with of renal cell carcinoma67-69 show that, although bone scan has a reasonable sensitivity and specificity, the probability of finding bony neoplasms in the absence of elevated ALP or bone pain is low. As such, the routine use of bone scan in the absence of bone pain or elevated ALP may be unnecessary. However, with the presence of symptoms and/or elevated markers, radionuclide bone scan is a useful test.

sblairc's picture
sblairc
Posts: 586
Joined: Feb 2014

There are no compelling data in the literature supporting the use of bone scan in the follow-up of patients with non-metastatic disease. This recommendation is based on studies indicating that in the absence of an elevated ALP or clinical symptoms, such as bone pain, the prevalence of bony metastases is very low (<1%). Routine imaging of these patients would result in a high rate of false-positive findings necessitating further burdensome, potentially invasive and resource intensive studies. As such, the routine use of bone scan in the absence of bone pain or elevated ALP is not required.

Jojo61's picture
Jojo61
Posts: 1310
Joined: Oct 2013

Thanks for all that info! I will certainly look up the American Urological Association recommendations on their website. The last time I had my bloodwork done for my scan, I asked for the results and he said it was very difficult for him to get me the results, since it was all electronic, but he read me 3 readings...my creatinin, hemoglobin and one other one (I can't think of the name of it, fromthe top of my head at the momentEmbarassed) . The creatnin was good but my hemoglobin was low - he wasn't concerned. My family doctor has since ordered some more bloodwork (he didn't receive all the test results from my oncologist either) to look into some other health issues I have. Bit by bit I am learning...I have been reading up on this stuff for almost a year...why do I still feel so clueless?

Thank you!

Hugs

Jojo

sblairc's picture
sblairc
Posts: 586
Joined: Feb 2014

I do all the research for my husband.  I've found it to be a tough balance between too much information (information OVERLOAD) and making sure I do my due dilligance. I don't think you are clueless, it's just SO MUCH information, knowing what sources to trust, etc. can be overwhelming. My husband has been NED for almost 14 months, and I still read his pathology report once a month making sure there wasn't anything I needed to research. What I've learned here, is be your own advocate for your health. 

vinnyc
Posts: 19
Joined: Jun 2011

i'm a former CT/MRI Tech. My rib mets did not show up on my CT scan and still doesn't, even knowing it's there. Bone mets to the 

veretbrae should show up. The ribs are just too thin, curved and angled to show up well on a thin CT slice. It may not even show up

on a bone scan. Sometimes just a simple x-ray of the ribs will show it very well, like mine.  I had radiation and i'm taking an injectable bisphosphonate, it can slow down bony mets by 50%.

Djinnie's picture
Djinnie
Posts: 945
Joined: Apr 2013

Hi Andy,

You sound extremely anxious, and of course that is natural considering the news. High anxiety causes adrenalin to rush into the body changing brain chemistry, this can cause you to feel ill in so many ways. Tingling, light headedness, spacy feelings, aches and pains headaches etc. I noticed in your December 4 th posting, you stated once you received your scan results the headaches etc. calmed and dissapeared. You know when we are very stressed and in fear we hold our bodies so tight, almost to the the point of rigid ie. Scared Stiff, your back will be carrying the brunt of that. The excessive fears could well be making your back feel out, your mind is also on constant alert, sweeping your body looking for the slightest twinge, because right now it can't focus on anything else.

All of this is only natural under the circumstances, but I think your anxiety may have reached such a level to be causing you pain. We all do body sweeps we can't help but do so, having Cancer you can't help but be on constant guard duty. We are more aware of every ache and pain, pains, which before the Cancer we paid little mind to unless they became more pressing. 

Do you have a date for surgery yet? Maybe in the meantime you should talk to your doctor and ask for something to calm your nerves, you may then find that some of these pains calm down, all of this stress is not helpful. I know your doctor feels 95% sure that it is Cancer but nothing is certain yet, you are racing ahead with your own scenario. Please put the brakes on until you know for sure, or you will drive yourself crazy. 

 

Djinnie x

 

 

 

dhs1963's picture
dhs1963
Posts: 511
Joined: May 2012

I can say with 99.9% certainty that the things you are feeling are related to anxiety or being 40+, and not related to cancer.  Most of us with stage 1 sized tumors had no -- nada -- zero symoptoms.  Those that did had things like blood in the urine:  peeing red.  And that is only an indicatior.  It does not mean that the cancer had spread.  You know you have the mass on the tumor, so if you pee blood, it provides no more indication.

One thing that happens as we go from the 30's to 40's is that muscles hurt more.  And they take longer to heal.  If you go on the internet, and ask is a specific pain related to metastatic RCC, the answer will be maybe.  Because there are no specific issues.  Odds are, if you had mets to the bone or brain, the disease would show metastisis to your lungs, and a more advanced presence in your abdomen.  There is no clinical reason for you to worry.  But we all worry.  

Good luck!  Talk to the Dr about anxiety medicine.  We have all been there.  Heck, my shoulder hurts today.  But, I am pretty sure the cause is arthritis, and not a met in the joint.  

Srashedb
Posts: 482
Joined: Dec 2013

since you have not had surgery yet, tsets are done to stage it; bone scans are one of the those tests.

my husband had 2 bone mets which were treated before the nephrectomy and his follow-up always include bone scans.

CT scans of the chest and abdomen may show bone mets depending on the location but the best diagnostic (according to the oncologist) is a bone scan or an MRI.

I agree with the others; don't make yourself crazy with anxiety. And, yes, that is much easier said than done.

Sarah

AndyE
Posts: 51
Joined: Nov 2014

Thanks for the comments everyone.  My appointment with the surgeon is tomorrow morning.  I will be sure to discuss this with him.  Those pains I get are so weird.  I can't tell if they are bone pains (although my mind attributed them to bones) or other pains.  The one along the side of my ribs almost feels like a bad bruise when you touch it and almost feels as if it is the soft tissue lying on top of the ribs.  Since I don't really know what bone mets feek like, I can't really say where it comes from.  Considering the absence of infection in my abdomine and lungs, and the size of the mass, I will go with the majority now and say that I am confident that there are no mets And let the doctors figure it out.  I know you all know this, but I would not wish having to go through this process and the anxiety that goes along with it on my worst enemy.

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donna_lee
Posts: 962
Joined: Feb 2009

8 years ago., US on a Tuesday, informed of the large mass in kidney (was 11.5x12.5.8 cm) and the one(s) in liver; consult with Onc. on Thursday; CT on Friday; Bone Scan on Monday.  Consulted with surgical specialists in Portland, OR, who reviewed all the tests.  What was found was operable and we did it.

Now take me back to 1985 and I was concerned about a tendernessiunder the left breast area.  It was diagnosed as a pulled inter-costal (between the ribs) muscle that would heal.  But for good measure and my age, lets do a mammogram; which led to a second one, and then a biopsy that was begnign.

The bone scan can rule out bone mets and that's what the initial scan was to determine; and that tells the oncologist what needs to be addressed in your care plan.  Tension in your neck, hips or back can lead to difficulty taking a deep breath, eating and digesting, as the nerves that branch out from the spine are supported and affected by the muscles they pass through.

Good Luck and think positive thoughts.

Donna

 

Djinnie's picture
Djinnie
Posts: 945
Joined: Apr 2013

Andy I am glad to hear you are meeting with your surgeon tomorrow, I hope he can allay some of your fears. I know it's not easy to keep a balance when you are facing such a challenge, but you will get through this though. Try and keep positive, we will always be here to help you.

 

Djinnie x

 

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foroughsh
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Andy

I was extremely nervous and anxious post surgery and before my first CT , So I used to talk to my surgeon at least once a week  and I had two or three relaxed days  after he reassured me that this pain or ache has nothing to do with my cancer but again my anxiety grew up  after few days so my friends told me all you need is to hear your doctor's voice Laughing. So I think it's good to talk to your doctor to let him know all about your pains from both physically and psychologically view. But in the meantime don't worry it's a time we all have passed. You'll be fine and come to your normal life after few months.

Forough


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nsb748
Posts: 90
Joined: Feb 2014

Some insurance companies (I know mine does)  offer a 24 hour line to an RN.  Not really a doctor, but if you have a quick medical question they can talk to you. 

Obviously they aren't going to diagnose you over the phone, but sometimes you just need a comforting voice from someone with credentials. 

 

Might be worth seeing if your insurance offers this service.

 

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