Hi, my fiancé had a 8 cm tumor in his right upper lung abutting a bronchial tube and pleura. He had radiation with 2 round chemo (cisplatin and etoposide). Tumor shrank to 4 cm. Question then was whether to do more chemo or wait (surgery was ruled out). Dr. said ok to wait 3 months and re-scan.
PET/CT 3 1/2 mnths later shows that 4 cm tumor shrank a tiny bit more but now a lymph node near the tumor lights up.
So... now one Dr. said to definitely start chemo now seeing that it is in a lymph node and another dr. said to watch and wait and re-scan in a few months. Both drs. believe it is cancer in the lymph node, with very remote chance it's only inflammation.
How critical is the fact that it's it is now in a lymph node to beginning chemo ?
Reply # - April 27, 2016, 09:26 AM
I hope you are both doing
I hope you are both doing alright. I'm going to see that a faculty oncologist comments.
Take care,
Janine
Reply # - April 27, 2016, 11:54 AM
Hi, thank you for sharing
Hi, thank you for sharing your fiancé's story. I think you received 2 different opinions about this situation because it is hard to know for sure if the cancer is really getting worse after only one scan. In fact, it is not usual practice to do a PET scan so soon after chemoradiation because often it can look positive when in fact there is only inflammation. PET scans are not nearly as accurate as many would like to believe, and in my experience are wrong as often as they are right in this sort of situation (with the caveat that I have not seen the scan so can't comment on this specific situation). It is certainly possible for the cancer to worsen so soon after chemoradiation, but the only way to know for sure would be to either do a biopsy or to wait and repeat the scan at a later date. If a patient is feeling well, there is usually little downside in waiting a couple months to be sure of recurrence before starting chemo. If the node is involved with cancer it will tend to get bigger with time and you can be more sure that you are doing the right thing.