Is my stage IV (both lungs have numerous nodules and ground glass opacities, left has area of consolidation) adenocarcinoma NSCLC "measurable disease"? Frustrated; cannot apply RECIST criteria to assess treatment reaponse. Radiologists haven't reported longest dimension of 5 largest lesions. Some don't count or measure. Some only compare to the previous scan, so I also am concerned if limited study of history of disease would affect their ability to identify whether or not a nodule was "New" or pprogressed. Had chemo, alimta maintenance and 4 month scan on optivo showed "improvement". Maybe PET would provide more feedback? I guess I need to ask more questions, not just about determining the response but making sure that however it is assessed is standard and that I be assured that everyone is taking into account the features of my individual disease. Do they know how my ground glass opacities differ from what some drug toxicity or paxlitaxel lung damage looks like. My one question is how has the WHO saying my disease should be meaaured? My oncologist has never considered BAC as if just because it's all called adenocarcinoma now that BAC clinically no longer exists. Any patients having similar concerns because their cancer doesn't "fit the mold" of being an easily measurable tumor? Thanks. Cindy
Nodules and consolidation measurement - 1273860
cindy121
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Reply # - May 2, 2016, 04:36 PM
Hi Cindy,
Hi Cindy,
If you have solid nodules and the radiologist's report simply didn't provide measurements, that's something that could easily be remedied, either by a review by your radiologist or by clinical trial staff reviewing the images. If all that is seen is in the nature of a GGO, measuring response is a bit more difficult, more of a judgment call (which doesn't fit well into the clinical trial concept).
It can always be an issue trying to determine what a hazy area on a CT represents, although I wouldn't think the effects of treatment would normally be mistaken for progression of GGO-like disease. You'd really want to ask your doctor about the specific features seen on the scan and get his/her opinion on whether there is any doubt about what the images represent.
JimC
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Reply # - May 2, 2016, 06:12 PM
Thanks JIm, I am not on a
Thanks JIm, I am not on a clinical trial (not that it makes a difference in my question) and, to be honest,. I don't know if I have "solid nodules". Some have been called ground glass nodules in aome of my reports. Some of my reports gave measurements, A subsequent report said they were appearing more dense. THe "hazy area " was first identified as pneumonia in August 2014 and again during alimta maintenance, the appearance of a cluster of new nodules was treated as infection. My first needle biopsy was taken from the "consolidation" in the ULL as far as I know. I am not dissatisfied with my care and treatment, it's just different in so many ways from the tumor questions here and on Inspire, that even when I have a good scan like this week, it just makes me want to know and understand more.