Focal booster cyberknife and PET scan - 1243107


hi all,

My wife Andre was diagnosed with nsclc stag IV (with brain tumour(last year and since then has had 6 ots of chemo which finished aug 2011.

after the chemo, the was only slight activity in the lung

Andrea has since had a further scan were there was a bit more activity on the lung so it has been decided to go ahead with "local booser cyberknife" which apparently goes on for 4hrs. She is a bit nervous about this and worries about silly things like will she be sedatted? will she be able to able to get up for the toliet etc ?
when i asked the doc if he thought the cyberknife will do a good job, his reply was something like "yes it will get rid of the insignificant little bugger!"

Also on the pet scan it said "Cervical issue, but not related and not a threat" the doc said oh thats nothing to worry about, but obviously we are as she feels a lump in her neck.
Would pet scan show previous damage or non cancerous problems ?

lastly she has been suffering Back pain and numbness down one side, she can put a hot cup of tea on her side and feel no pain ? would this be related ?

thanks in advance x



Hello, I can't say anything about booster cyberknife. It sounds like the doctor thinks he can get rid of the local problem with it. I assume the brain met has been treated and stablized?

If there is only a tumor on the lung and one in the brain it is possible that the onc is hoping to cure your wife but if there is more cancer than just the 2 spots it is likely that the onc would focus anti cancer treatment systemically such as chemo and save radiation as a paliative measure such as the cancer causing pain or blocking an airway.

It also sounds like she is having symptoms that may not have been checked out. Has she talked to the onc about these other symptoms? That would possibly change her oncologist's focus of therapy. These sound like good questions for her onc.
Also 2nd opinions are usually looked at as a good thing in cancer; 2 heads are better than 1 kind of thought. Here's a link to a blog written by one of Grace's oncologists, Dr. Weiss

And as a wife of a nsclc patient I'd suggest that nothing your wife thinks or feels is silly ...or It's a horrible situation and "we all" should be allowed wild silly thoughts.

I hope this is helpful,

Dr West
Posts: 4735

You'll need to talk with her radiation oncologist about the details of the radiation. That's part of the process of preparing someone for the procedure.

A PET scan showing uptake is suggestive of cancer involvement, and I presume they meant to say that this represents an involved lymph node, which is common, but there isn't a clear reason to treat it if it isn't causing symptoms. Treatments aren't generally given just because someone feels a lymph node and is worrying about it, but if it were causing pain, or if it is possibly pressing on a nerve and causing the symptoms you're describing in her arm, that would justify perhaps doing radiation to shrink it and relieve those compressive nerve symptoms.

PET scans show increased metabolic activity that can range from cancer to inflammation or infection, but it doesn't say what the underlying cause is. We can generally infer that certain areas have cancer based on the patterns of cancer spread, but there are many situations when we don't really know the cause of an area of PET uptake until we do a biopsy.

-Dr. West

certain spring
Posts: 762

Just wanted to offer that I've had a lot of radiation - though nothing lasting for as long as four hours - and the technicians/support staff are usually very considerate and careful of the patient. In my experience the radiation is not continuous - they stop for breaks in case you need to move or cough for example, so I expect the same would be true for a toilet break. I am sure your wife will be able to have sedation should she wish it. She may also find that the radiographers are able to talk to her and reassure her via speakers in the radiotherapy suite. I actually found radiotherapy quite relaxing, certainly by comparison with chemotherapy and surgery. Sometimes they play music and I believe some hospitals let you bring your own.
Please do pass this on to your wife. I am glad she is doing so well.