CT chest and Bone Scan clear, Metastases possible?

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This topic contains 2 replies, has 2 voices, and was last updated by  shoeluver65 3 weeks, 4 days ago.

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November 22, 2017 at 4:54 am  #1293551    

shoeluver65

Hi there

My 83 year old dad was diagnosed with Stage 1B NSCLC 2 1/2 years ago. He chose not to have surgery but instead had radiotherapy, which seems to have stabilised the tumor – the CT’s he has every 6 months show that the tumour hasn’t changed in size or spread. About 2 months ago he started to feel weak, low appetite, has lost 4-5kg, his cough increased in frequency and severity. About a month ago he started having upper back pain near his spine and radiating up to his head and to the front of his face. After seeing his local doctor and being sent to have a CT chest and bone scan which all came back clear – only showing arthritis and pneumonitis, he still has this pain and it has become more frequent and is there every day now. He has started taking Tramal for the pain which is a slow release drug and lasts about 12 hours, this is controlling the pain well but as soon as the 12 hours are up the pain starts coming back. Around the same time as these symptoms started he was also started on 2 new cardiac drugs – Perhexelline and Entresto. I was just wanting to ask if its still possible there could be metastases even though the bone scan and CT both didn’t show any, is it a good idea to ask the doctor if he can have an MRI. Or is it possible his new cardiac drugs could be causing these symptoms as side effects. We have an appointment to see his Oncologist on Monday so hopefully will get some answers then, but as you can imagine we are all feeling very stressed as we await that time. He used to be a reasonably fit 83 year old up until 2 months ago, and its very sad to see his quality of life snatched away from him.
Thank you

November 22, 2017 at 6:28 am  #1293553    
JimC Forum Moderator
JimC Forum Moderator

Hi shoeluver65,

Welcome to GRACE. Although it’s good to hear that the radiotherapy your dad received seems to have kept his cancer under control, I’m sorry that he’s experiencing these symptoms. Of course, when there is an existing cancer diagnosis the tendency is to attribute every new symptom to the cancer, and it’s always appropriate to report those new symptoms to the oncologist. It would be unlikely (though we always hesitate to say “impossible”) for such significant symptoms to be caused by a bone metastasis or progression in the lung that doesn’t appear on scans. Of course, cancer patients can experience the same illnesses that any person can, and these symptoms may not be directly related to his cancer.

I haven’t seen these types of symptoms reported with either of his cardiac drugs, although it wouldn’t be a bad idea to confer with your dad’s cardiologist just to cover all possibilities.

I don’t see any reason you shouldn’t ask about an MRI, especially if your dad’s doctor doesn’t have another theory about what could be causing his symptoms, as it certainly seems that further workup of some kind is necessary to diagnose and address his problems.

I hope you have an informative and productive meeting with the oncologist on Monday.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

November 22, 2017 at 6:26 pm  #1293554    

shoeluver65

Hi JimC

Thank you SO much for getting back to me. It means a lot. You have given me some hope.
Dad has an appointment with his Respiratory Physician this afternoon so we can ask about dad’s cough which has been getting worse in frequency and severity so hopefully he can suggest something for that. He also has a cardiologist appointment tomorrow to review his medication and discuss the possibility for a pacemaker/defibrillator device. I don’t think I mentioned in my post that Dad has heart issues, low ejection fraction, 2 faulty valves and AF. And of course Monday for the oncologist. I’m on a mission to find out the cause of his health decline so hopefully after all these appointments we’ll know something. In the meantime I will keep praying and trying to be patient.

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