Compete Metabolic Response - 1261803

harmeet
Posts:4

My father just had his second PET/CT scan last week after 6 months of treatment. The Final impression on the scan stated "complete metabolic response to the treatment." Does it mean that treatment is working? Or does it mean that nothing showed up on the scan? I am confused with the term.

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Reply # - January 28, 2014, 09:30 AM

JimC
Posts: 2753

Hi harmeet,

Congratulations on your father's great scan result!

As Dr. West has written:

"...PET scans offer “metabolic imaging”, which detects differences in the metabolism of tissues. The most metabolically active tissues have the greatest needs for sugar from the bloodstream, and when the sugar is labelled, the scans detect these areas as “PET-avid”. The objective measurement is a number called a “standard uptake value”, or SUV, where higher numbers mean a higher metabolic rate. While metabolic activity can be increased with inflammation, infection, and normal body activities (organs like heart, brain, and bowel have uptake normally from regular ongoing activity — this is NOT a bad thing) the reason we all care is that PET scans tend to pick up cancer, because cancer cells generally have greater metabolic activity and are dividing faster than most normal tissue." - http://cancergrace.org/cancer-101/2007/01/09/pet-scanning-intro/

So when the report says "complete metabolic response", that means that the PET shows no PET-avid areas...treatment worked exactly as intended!

JimC
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Reply # - January 28, 2014, 10:56 AM

Dr West
Posts: 4735

Yes, I agree completely. It suggests that even if there is a residual nodule or mass, it may not harbor any viable cancer at this time. Very nice to hear!

Good luck.

-Dr. West

Reply # - January 30, 2014, 12:11 PM

harmeet
Posts: 4

Dad just his follow up appointment with his Oncologist. The Oncologist was pleasantly surprised with the outcome of PET result. At first, the Oncologist contemplated about stopping Chemo or keep it going. After a discussion he said that Dad has minimal side effects to the GemCarbo treatment, so the Oncologist wants to keep it going for another 3-4 cycles. He called it the "consolidation" period. He said it used to be that we would take people off Chemo but now the new trend is to keep them on Chemo little bit more. Do you have any experience and/or feedback regarding this?

Reply # - January 30, 2014, 12:46 PM

catdander
Posts:

Here's a link to blog posts on the current thoughts about consolidation treatment of locally advanced nsclc. http://cancergrace.org/lung/tag/consolidation-chemotherapy/
There's never a single answer to the question of whether to continue treatment or not. One thought on what you mentioned is that usually the platinum drug, in your dad's case carboplatin is stopped because it so often causes hypersensitivity after around 6 treatments.

I hope you find lots of useful information for you and your dad to consider.

All best,
Janine

Reply # - January 30, 2014, 10:12 PM

Dr West
Posts: 4735

If this is treatment for metastatic NSCLC, then it's more typically called "maintenance therapy", which is commonly done for patients who are responding and tolerating treatment. However, it's definitely NOT a mandate for patients who want or need a break, and even those of us who offer or recommend it for some patients don't usually recommend it for everyone. If patients can get the same treatment later, it's probably every bit as good as continuing with more chemo right after first line. There is a lot of material here about maintenance therapy if you just do a quick search for it.

If this is treatment for stage III or some other curative setting, there's no evidence that continuing treatment beyond 4 cycles provides greater benefit than stopping after 4 or even possibly 2-3 cycles (usually about 6-8 weeks of chemotherapy).

-Dr. West

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