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Much ado about Pancreatic Lesions

NYNY83
Posts: 8
Joined: Mar 2018

About a month ago I posted a question about my CT scan that showed two small pancreatic lesions.  I'm four years past my partial nephrectomy for a stage 1, 2 cm tumor, and have had relatively clean scans in the interim.  Of course, my urologist was on Spring break vacation, so it took a few weeks to get in to see him.  His initial reaction was one of low concern, given the low likelihood of this type of cancer metastizing to the pancreas.  His plan was to check with the radiologist and ask him to compare the CT with the prior year's MRI.  (The comparison had been to a CT from 3 years earlier.)  It turned out that the lesions were there a year ago and had not grown. Though they were slightly bigger than three years earlier, both doctors deemed it low risk.  So what did I learn from this experience:

  • This site was a godsend.  The responses to my post helped me put things in some perspective and keep my sanity.  The uncertainty surrounding the results freaked me out this time, perhaps exacerbated by my current unemployed status and a resultant too much time to dwell on the negative outcomes.  None of us chose this journey, but it sure helps to know that we're not venturing down this path alone. So thanks to all for the support.
  • There's a tremendous amount of ambiguity in MRI and CT scans.  Different radiologists will read the same films differently.  I even once read about a study where the same radiologists diagnosed the same images - unbeknownst to them -  differently.  Plus, some radiologists mention everything they see; some only note the highlights.  
  • Trying to stay positive is essential.  As a natural pessimist, I struggle with this.  However, focusing on worst case scenarios doesn't change the actual outcome, and makes it that much harder to get out of bed in the morning.  
  • Maybe these brushes with our own mortality can enable us to cherish the limited time we have.  As Jim Morrison wrote, no one here gets out alive.  In our day-to-day preoccupations with often trivial pressures, it's easy to ignore the inescapable outcome.  Cancer can force us to ask the tough questions about what is important and where should we allocate our limited time, and thereby perhaps help us learn to live a bit better.
cubsfan9
Posts: 62
Joined: Oct 2013

Good Morning!

Glad to hear it was 'much ado about nothing', although I'm sure waiting for the news was stressful.  Your doctor was wise to go back and have a comparison of the scans reviewed.

I hear you loud and clear about the radiologist reports!  We are kind of going through the oppisite scenario right now.  My husband had a large (6 cm) pancreatic met discovered just over 5 hears ago.  In looking back, it had been there and missed in previous studies.  So...fast forward five years and many rounds of Sutent.  The mass shrank over time to about 1 cm and at various times scans picked up other areas "of concern" that were to be watched.  Last week's scan report came back saying NOTHING!  Pancreas appears normal.  No indication of activity in lymph.  While that is great news, it leaves me scratching my head.  Things that have been noted repeatedly are suddenly "gone".  Oncologist seemed almost defensive of radiologist and did not offer to have then take another look.  I hope it is correct!

Allochka's picture
Allochka
Posts: 826
Joined: Nov 2014

Great to hear about good results! Things which do not grow for a year are not mets :-)

 

Cubsfan, if you are worried, perhaps you could seek second opinion yourself? There are online trustful sites which employ highly qualified radiologists, who could do it. Hopefully lesions are really gone (this is not unheard of on this board, such things do happen to Stage 4 people)

cubsfan9
Posts: 62
Joined: Oct 2013

Thanks.  We did have the disk sent to the urological oncol for his opinion.  I should note that the scans were done without IV contrast and, of course, the report was hedged with "suboptimal due to lack of IV contrast" comments.  Next scans in October are supposed to be done with contrast, so we'll see what they show.  We, too, are hopeful that everything is really gone--that's the goal!!  It just seems too good to be true that EVERYTHING previously noted disappeared at the same time.  In the meantime, things are stable enough that Sutent dosage has been lowered to 25 mg in hopes of improving quality of life.  Stay tuned...

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