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HL- Son just finished chemo, but still has small mass in chest. Hmmm

cshelz
Posts: 1
Joined: Apr 2018

Hi

 

 

New to the boards. My son (15) was diagnosed with HL Dec 2017z we just finished chemo (5 cycles) and had CT scan. Well, the doctor said there is a small mass still showing, so she wants to do a PET. She said it’s most likely dead cells, but wants to be sure. She also said no rush on doing the scan. I’m so nervous and can’t stop worrying. Is in common to show a small mass even after chemo? The tumor in his neck is completely gone, but the chest tumor shrunk from a 5.5 to a now...after chemo, 1.9. 

We were to keep moving forward with radiation simulation, but hold off doing until we get a Neg on Scan. 

 

Thanks so mich

Michelle 

 

ShadyGuy's picture
ShadyGuy
Posts: 397
Joined: Jan 2017

i had tons of scar tissue which showed up on CT scans but did not glow on PET. Its likely ok but you want to be sure. I think a PET is the way I would go. You cannot overstate the value of peace of mind.

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3293
Joined: May 2012

Michelle,

The doctor seems pretty confident here. You do not state his type of HL (there are 5), but most are pretty easily put in to full remission.

A PET is definitely advised; I would have supposed even routine.  As Shady stated, scar tissue remaining after total remission is common.  I asked my oncologist what becomes of huge nodes in remission, and he said that "some remain as 'shells' in effect, sort of like burnt out pecans."

Even IF there is a little Hodgkin's remaining, it is extremely likely that killing off the remainer would be pretty easy to do -- perhaps as simple as another round of chemo or two. The most common HL combination is ABVD, what I received.  Dosing would allow him to receive six or more total cycles (I received six), and I've heard of patients getting even 8 cycles.  In other words, a few more infusions is completely possible if deemed necessary. I got 140% of lifetime recommended dose, but I have friends at the Board here who have received 400% or more of recommended lifetime dose of many drugs.

Very generally, HL is usually not as dangerous as some of the more aggressive non-Hodgkin's (NHL) substrains out there.  If only one  or a few tumor(s) remain(s), spot radiation alone can do the trick with a technology called IMRT (Image-guided radiation technology).  Stage 1 HL is commonly attacked with just radiation therapy. 

We hope the PET is completely clean, but either way, he very likely will get to total remission soon.

max

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