P.E.T Scan results Need insight please!!

Portal Forums Cancer Basics Imaging Issues P.E.T Scan results Need insight please!!

This topic contains 9 replies, has 7 voices, and was last updated by catdander forum moderator catdander forum moderator 1 year, 9 months ago.

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October 23, 2012 at 9:54 am  #1249381    

mommabanks4

Here is the brief history, had two ct scans blood work and a p.e.t scan. Im a 29 yr old female no history or family history of cancer. P.e.t scan results show (head/neck) intense symmetric activity with in both tonsillar fossae and walls of nasopharynx and oropharynx (suv max 1.4-1.5) less intense symmetric bilateral hypermetabolic activity in the submandibular salivary glands. Multiple enlarged hypermetabolic upper cervical chain lymph nodes bilaterally (suv max approximately 7) there is also a single enlarged hypermetabolic left supraclavicular lymph node. (thorax) soft tissue densities in the anterior upper mediastinum demonstrating minimal bhypermetabolic activty (suv max 3.4) No other foci of pathologic hypermetabolic activity. Large gallstones incidentally noted. What does that all mean?? I had a follow up with my doctor but left the appt not gaining any knowledge of what was going on?? Did have any real answers to my questions. Is sending me to an e.n.t for additional evalution but didnt explain why when I asked why just said to rule stuff out. Any information on this would be greatly appreciated!!!

October 23, 2012 at 12:18 pm  #1249383    
catdander forum moderator
catdander forum moderator

Hello mommabanks,
Welcome to Grace.

I’m sorry youre going through such trying times. How odd that the doctor didn’t explain anything to you except to say…stuff. Not at all very helpful. I suspect you know that hyper-metabolic activity can suggest cancer. I hope you know too that it could point to infection or inflammation. I wonder if your doctor mentioned these things.
It isn’t possible for a doctor to read your report verbatim and know what it means. There is the matter of the person, the pictures, and history that need to go with it to complete the picture of what’s going on.

I suspect you want to know something about the areas of hyper metabolic activity (aka uptake or suv #s).
Anything that is “incidental” isn’t likely to be of importance…unless it’s causing a lot of inflammation in your lymph system.

I’ll contact a doctor to give input on those issues of uptake. You should get a response within the day.

I hope all is well and easily explained and cared for at your next appointment.
Janine
forum moderator

October 23, 2012 at 12:25 pm  #1249384    
catdander forum moderator
catdander forum moderator

Please read this article from our FAQ library. It will help greatly in your understanding. http://cancergrace.org/cancer-101/2010/09/14/cancer-101-faq-primer-on-pet-scans/

October 23, 2012 at 12:43 pm  #1249386    

mommabanks4

Thank you for taking the time to.respond to my concerns. I got the infoation I provided from a copy of the p.e.t scan results that I requested because i did.leave with unanswered questions. The “stuff” the doctor talked about was so broad n random I didn’t feel I got anything of value. He.did mention possibilities of infection or lymphoma which are on broad spectrums to me. All of.this was found on accident which am thankful for which lead to further blood work n the pet scan. I am not sick nor am i showimg any signs of a cold. So this leaves me wondering what is going on!!! I guess just not knowing is the hardest part being as I’m always healthy n the mother of 4 young children. Understand the p.e.t scan results i feel would give me more knowledge on what to expect. Again thank you n i look forward to hearing more.

October 23, 2012 at 1:26 pm  #1249387    
JimC Forum Moderator
JimC Forum Moderator

Hi mommabanks,

Just to add to the excellent information and link Janine provided, the main thing to be aware of is that PET scans can light up for all kinds of reasons, often not cancer. The only procedure that can definitively determine whether cancer cells are present is one in which tissue is collected from the suspect areas and tested for cancer cells. And there are many examples here on this site in which members have posted similar questions and later found that there is no cancer present. That’s not to say it isn’t difficult to avoid thinking the worst…that is a common reaction. But please try not to assume it’s cancer.

If you have any further questions, please post them as they come up, and don’t hesitate to post just for support from the GRACE community.

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

October 23, 2012 at 2:18 pm  #1249388    
Dr West
Dr West

I think the key point is that infection or something like lymphoma (particularly Hodgkins lymphoma in a young person), or less commonly another cancer, could cause enlarged and hypermetabolic lymph nodes, but the only way to know what’s going on is to get a biopsy. Until then, it’s all guess work.

Good luck.

-Dr. West

October 23, 2012 at 4:05 pm  #1249394    

cards7up

Ruling out “things” is the way they get to a diagnosis. Even those of us that have been diagnosed with cancer have to go through all kinds of tests to get to the end result. But as Dr. West said, only a biopsy can tell for sure if it’s cancer. Wishing you the best. Take care, Judy


Stage IIIA adeno, dx 7/2010. SRS then chemo carbo/alimta 4x. NED as of 10/2011.
Local recurrence, surgery to remove LRL 8/29/13. 5.2cm involved pleura. Chemo carbo/alimta x3. NED

October 23, 2012 at 8:19 pm  #1249407    

Dr. Weiss

PET works by seeing where sugar goes. As others have noted, things that take up sugar include infection, inflammation, and cancer. The ENT will examine you, review blood test results, and look at the actual images from the scans to determine the next step. Biopsy from the areas describe is typically easy with very low chances of complications or even major discomfort. You should be aware that even if cancer is found, that we cure cancer all the time. Given your age, the most likely cancer (if cancer is even present) would be lymphoma–most of the lymphomas rank up their with the easiest to cure cancers.

One technical point that you may wish to make sure that the ENT is aware of (some nonacademic surgeons might not be savvy to lymphoma) is that a test called “flow cytometry” is important to order on biopsies where lymphoma is being considered. It’s a test that needs to be ordered on fresh tissue and pointing this out could potentially save you from needing a second biopsy. Please don’t misinterpret my comment as in any way suggesting that you have lymphoma; that’s not what I mean; rather, I mean to make you aware of this to avoid the possibility of having to get more than one biopsy.

February 1, 2016 at 9:54 pm  #1272823    

lalexander71

As I am new here and following some of the questions, my husband just recently had his PET scan after very intensive treatment for a Pancoast Tumor, with Horner’s syndrome- (poorly differentiated adenocarcinoma). His Pet scan showed the tumor has shrunk 1.5 cm in each directly and no signs of spread. HOWEVER- the CEA (tumor Marker) started in October at 26, then went up to 41.5, and then down to 29 same day as the PET Scan, but now 1 month later, the CEA blood lab- still showed the CEA level at 29, when if should be going down, and the normal range is 2.4.

Dr. West or Dr. Weiss- can you make sense of this??? I to, am trying to make sense of all of this wording in the report- and even after asking 10-20 times still did not get a solid answer of what stage this was in October, and what stage is it now. They did say it was isolated in apex of lung and did not show any spread to lymph nodes (which I read would then be stage I), but not sure.

LD

February 2, 2016 at 12:11 pm  #1272828    
catdander forum moderator
catdander forum moderator

Hi LD, I think Dr. Creelen covered this in his post, CEA levels don’t say anything about lung cancer.
I’m so sorry about what your husband is going through and hope he regains strength and energy.
Janine

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