Hi Dr. West and team,
My mom was diagnosed 15 months ago with Stage 4 Adenocarcinoma. The nodules were limited to the left lung and there was malignant pleural effusion. She tested negative for major mutations. Her first line chemo was Alimta + Carboplatin and this combination suited her. Since completing 6 rounds, she has been on Alimta maintenance for the last 8 months. She feels really well and her 3 month CT scans have indicated stable disease.
This morning, she received the result of a PET scan comparing the result with a PET from last year. While the conclusion states "significant regression", they note: "a large solitary hypermetabolic node is identified in posterior mediastinum, at the arch of aorta measuring 12mm x 19 mm (SUV max 6.7) - Compared with previous PET imaging (March 2014), this is a new finding."
Can you please guide me as to what this might mean? I'm praying it isn't progression. My mom (aged 74) is at least outwardly, symptom free and super active.
Thank you so much,
Semone
Reply # - June 9, 2015, 08:35 AM
Hi Semone,
Hi Semone,
An enlarged, hypermetabolic node can have a number of different causes, such as inflammation or infection, not necessarily indicating progression. Of course, in the context of an existing diagnosis of lung cancer, this finding is suspicious for progression. But since your mom has done so well with Alimta maintenance, is feeling so well and this node is the only finding, your doctor may wish to watch it closely with follow-up scans rather than discard a treatment regimen that has been effective.
Although it may seem imperative to get on top of any small indication of progression as quickly as possible, Dr. West has often stated that finding and addressing new progression a few weeks or even a months earlier does not affect results:
"[T]here is no evidence, nor reason to believe, that finding metastatic recurrence a little earlier vs. a little later will lead to a better outcome. If it recurs as metastatic disease, it isn’t curable, for all intents and purposes, so there is no reason to focus too much on finding out about a recurrent, incurable cancer long before the first symptoms would tell someone. I see the big value of screening and surveillance as the ability to detect local recurrence, which might be curable, or a new, distinct cancer." - http://cancergrace.org/topic/has-5-year-mark-to-consider-cure-for-nsclc…
JimC
Forum moderator
Reply # - June 9, 2015, 11:09 AM
Thank you Jim, as always, for
Thank you Jim, as always, for such a thorough response. I cant thank you enough. Regards, Semone