Neoplasm same area previously Cyberknifed

Portal Forums Radiation Oncology General Radiation Oncology Neoplasm same area previously Cyberknifed

This topic contains 4 replies, has 3 voices, and was last updated by Dr West Dr West 3 years ago.

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November 16, 2014 at 7:17 am  #1267158    

koal

Original Adenocarcenoma 3x5x3 cm was Cyberknifed 3 1/2 years ago. Eighteen months after initial treatment PET showed a possible recurrence in Hilar Lymph Node. Treated with external beam radiation and four rounds of chemo. Have been NED since. PET scan 4 months ago was NED.
CT scan last week and radiologist stated “ill-marginated mass 3.5 cm apparently represents neoplasm” and went on to describe the fiducials that were placed for the Cyberknife as brachytherapies seen embedded within the mass. This area that was originally treated was described as “air space” in previous reports.
Could this “neoplasm” be something other than a recurrence in the area of the original tumor?

November 16, 2014 at 8:33 am  #1267162    
JimC Forum Moderator
JimC Forum Moderator

Hi koal,

Although anything is possible, the radiologist and other members of your medical team can interpret your scan much better than anyone here. Apparently what they are seeing now looks different enough from what was seen on previous follow-up scans to lead them to conclude that this may be a recurrence. Discussing these finding with your local doctors may help clarify the situation for you.

If there is doubt, you could also obtain a second opinion to help set your mind at rest.

Good luck.

JimC
Forum moderator


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November 16, 2014 at 9:05 am  #1267166    
Dr West
Dr West

It’s always worrisome if an area of previously treated cancer shows progression, but it’s also notoriously difficult to interpret changes that occur after radiation, especially cyberkinfe. 3.5 years out is pretty late to see anything looking worse, but nothing you’ve described clearly notes progression. It’s typical to have post-treatment residual scarring, and sometimes the scarring after radiation is larger than the original mass being treated.

For this reason, we absolutely don’t want to conclude that someone has viable cancer just based on the residual findings on a scan. You’d want to see clear PROGRESSION, and if there’s any room for doubt, we strongly prefer to get a biopsy to prove viable cancer…simply because it can be so hard to interpret scan findings after prior radiation.

Good luck.

-Dr. West

November 16, 2014 at 9:18 am  #1267167    

koal

Could scarring show up three plus years after Cyberknife and look like a mass? Is it likely to have a “mass” grow from air space to 3.5 cm in four months?
Thank you Dr. West for your dedication.

November 16, 2014 at 9:47 am  #1267174    
Dr West
Dr West

“Air space” doesn’t mean anything without seeing it, and the term “air space disease” is a vague term that doesn’t give a clear sense of what was there before. I can’t see the images, so I can’t interpret what’s happening. It will be necessary to speak with your doctor about the potential significance of the change, because the pieces of what you’re relaying don’t fit together. Interpreting the images requires seeing the images.

Good luck.

-Dr. West

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