Good day to all doctors and members,
My mother(Age:43yrs,non-smoker) underwent a PET-CT scan today and it stated the results as follows:
1. Metabollically active spiculated lesion in the paramediastinal region of anterior segment of upper lobe 3.2x2.1 cm with a
(SUV MAX=4)
2. INCREASED FDG uptake noted in the patchy lysis with adjacent soft tissue thickening in neck of left 12th rib with (SUV
Max=3.5)
3. Focal increased FDG uptake noted in D12 vertebral body with a (SUV Max=3)
4. No evidence of significant pulmonary nodules.
5. No evidence of metabolically active disease anywhere else in the body.
6. No evidene of metabolically active left hilar/mediastinal lymphadenopathy.
Is there a surgey possible in her case??? Could this be considered as oligometastases??? Please suggest some options
Reply # - October 1, 2014, 02:10 PM
Hi raghav93,
Hi raghav93,
Welcome to GRACE. I am sorry to hear of the findings from your mother's scan. It's not clear whether she has a definitive cancer diagnosis from a biopsy, but if these findings represent cancer, then the presence of bone metastases normally precludes surgery or radiation, except to relieve pain or prevent fracture, especially of a load-bearing bone. The problem is that the cancer reached the bone through the bloodstream, and there are very likely additional cancer cells circulating throughout the body. These links may prove helpful:
http://cancergrace.org/cancer-101/2011/01/01/cancer-101-faq-i-have-meta…
http://cancergrace.org/lung/2010/09/07/local-therap-for-metastatic-dise…
If treatment has not begun, then normally chemotherapy or targeted therapy (if genetic testing has revealed an activating EGFR mutation or ALK rearrangement) would be recommended. This GRACE FAQ on first-line treatment (as well as a number of links to other relevant posts) can be found here: http://cancergrace.org/lung/2010/09/18/lung-faq-ive-just-been-diagnosed…
JimC
Forum moderator
Reply # - October 1, 2014, 07:45 PM
Yes, it sounds from the
Yes, it sounds from the description of her scan that this is likely to be beyond the range of what can be treated feasibly with surgery, but an online impression from people who can't see the images and don't have all of the details is no substitute for the evaluation from the doctor(s) directly involved with her care. If there is direct involvement of bone by the primary tumor, it is sometimes possible to do a surgery, but this is usually a very involved process. A surgeon looking directly at her films would be equipped to make that judgment.
Good luck.
-Dr. West
Reply # - October 2, 2014, 09:26 AM
Thanks a lot for your reply
Thanks a lot for your reply Dr.West. My mother is suffering from direct bone involvement from the primary tumor as you said. it is being invaded.. Is cyberknife applicable in my mother's case doctor?? As some oncologists run oligometastases program , i am confused regarding the use of radiation oncology in my mother's case
Reply # - October 2, 2014, 10:15 AM
Radiation can be very
Radiation can be very successful at relieving pain from bone involvement and maybe in you mother's case. I'll ask our radiation onc to comment on the possible use of cyberknife vs conventional radiation treatment.
I hope all goes well for your mother for a long time,
Janine
Reply # - October 2, 2014, 01:19 PM
Good question...
Good question...
The answer on a higher level depends on whether some form of radiation therapy directed at the known tumor masses will eventually be helpful. Most of the time, we would start with a systemic therapy. If no additional sites develop, we would consider treatment to these areas of disease that have shown up on the scan. (We would think about treatment with radiation now or sooner if any of these areas are causing symptoms).
Whether stereotactic irradiation (high dose, image guided treatment) would prove better than conventional irradiation depends a lot on specific anatomic considerations of these sites of disease... I defer to your physician team and radiation oncologist on this.
I hope that helps.
Dr Loiselle