CT scan too late? - 1253276

didi85
Posts:7

Hi,

We have just received my dad's (stage IIIB, completed chemo and radiotherapy) PET results and I'm a bit disappointed. It says that some lymph nodes are comptible with residual malignancy. The lymph node with the highest FDG uptake is SUVmax 11 and all the others are around 2,5 and 3,6. In the CT scan 1,5 months ago, he appeared to be NED. He caught a terrible pneumonia-like cold two weeks ago and I suspect this is the reason behind his detoriation (he now looks perfectly healthy though).

His oncologist said the results are not so clear and he scheduled a CT scan 6 weeks later.

However, this is exactly what worries me.

Isn't it too late?

My dad received his last chemo in October and if we wait for the Ct results, it will be 5 months without treatment.

Thanks!

Dilay

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Reply # - February 1, 2013, 09:26 AM

catdander
Posts:

Hi didi, I'm so sorry your dad is going through all this and hope he comes through cured.

It sounds like he has some individual issues that may not be easily answered. However you will find that to be the case possibly more often than not.
It is perfectly reasonable to have a second opinion to help clarify what's going on and what reasonable expectations for being or becoming cured are.

I'll ask a doctor to comment on your questions. You should hear back within the day.

In the meantime it's a good sign that your dad looks perfectly healthy.

Janine
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Reply # - February 1, 2013, 12:05 PM

dr. weiss
Posts: 206

Imaging in the year 2013 is much better than ever before. CT imaging lets us see the body in 3 dimensions. We can see smaller lesions than ever before. PET allows us to see how (metabolically) active a spot of concern is. However, much as our imaging is better than ever before, it still has substantial limitations. Imaging cannot tell us for sure what many spots are. When imaging is ambiguous, we are at risk of two key mistakes. If we get aggressive and do surgery or radiation on spots of concern, we will over treat some patients, with resulting side effects and even death. If we completely ignore ambiguous spots, we can risk allowing cancer to grow and missing opportunities to do benefit. One day, imaging will be more perfect. For now, with these two competing risks of over and under treatment, careful observation with a short interval CT can be VERY helpful. Things that grow and get more hot are concerning, and we get more aggressive. Things that stay the same, shrink, go away, or become less hot are less concerning; we can either be reassured, or keep following.

I can overemphasize how often careful watching can be the right answer. While it can be nerve wracking, it has saved many patients from unnecessary complications.

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