The found a "spot" on my mom's lung... 18 months post op. - 1249200

Thu, 10/18/2012 - 10:49

I'm anxiously awaiting the results of my mom's PET scan performed Tuesday. They have chosen only to do chest x-ray's post op with my mom and up until the x-ray were clear. Now they say there is a spot so they did a PET scan. I guess there was some mention of a staple from her lobectomy surgery and I assume they mean scar tissue.

I'm not sure what I'm here to ask... does scar tissue show up 18 months post op? How long does a PET scan take to get the results? I guess they would biopsy it next right?

I wish they could get results faster...

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Dr West

I'm sorry to hear that you're awaiting results at a scary time. Scar tissue doesn't usually appear a year out from a procedure, but it can definitely persist indefinitely if it was there previously.

It typically takes a minimum of several hours, and sometimes a day or two, to get results from a PET scan or PET/CT scan. There's a lot of data to be reviewed.

I suspect a biopsy would be pursued if the spot lights up on PET (meaning it has high metabolic activity). If it doesn't light up on PET, it would be more reassuring and likely lead to a plan to just repeat imaging studies to see whether it grows, stays stable, or even shrinks over time.

Good luck.

-Dr. West

clemclem44

It showed up on the PET as did a spot in her "throat" (my dad is terrible at relaying information). Her biopsy is Wednesday and resuls we expect by Friday.

What questions do I need to ask? I've sent my brother to be there so he can help gather the information. Though it feels very much like I'm the only one who wants to REALLY know what's going on. I think her radiologist and oncologist realize that my mom's pretty freaked out so they never really go into detail here.

She won't do any chemo - and they would only consider radiation if it was to save her life since she had already had so much when she had breast cancer. But if not framed right then I think whe will just give up.

The questions I'm already wanting to ask is what kind of cancer is it? NSCLC again or SCLC etc?
What are the symptomatic treatment options? I read about cryo knife or something - primarily if she does have a tumor in her throat or esophagus?

Heads spinning. I tend to not process in the moment and get way far down in the future which sounds scary and terrible. I just want to get as much information as possible.

many thanks for always responding. I can't tell you what a comfort it is.

catdander

I'm very sorry your mom is going through yet another cancer involvement. I can't imagine once much less 3 times. From your bio it sounds like your mom's adeno may have recurred, but by your question above you're not sure of that? So yes if it is the same cancer it would be considered a recurrence and would not be considered curable but could be treated for symptoms.
If it is thought to be a new primary cancer it could possibly be treated with curative intent.

A lot depends on the unknown. The biopsy will hopefully answer a lot of questions then a plan can be made. Plus it sounds like your mom would need an individualized plan because of previous treatments and treatments she wishes to avoid.

Below is a link to an introduction to lung cancer. There is much written here on the subject but without knowing what type of cancer, what stage, and very much what her individual issues are it is impossible to say what her options will be.

I will ask a doctor to comment on your post. They always provide wider and clearer perspective.

Janine
forum moderator

catdander

I left off the links in my previous post.

It really is difficult to know what to suggest you read until you know what your mom's dx is.

Below are excellent intros for those with advanced cancer. Please let us know what you find out.

http://cancergrace.org/lung/2010/10/10/overview-of-molecular-markers-in…

http://cancergrace.org/lung/2010/09/18/lung-faq-ive-just-been-diagnosed…

Dr West

It's most likely it's the same cancer, though if there is doubt, a biopsy can be done to clarify/confirm. After that's done, it's important to clarify where it is. If in only one location, radiation would make sense. Otherwise, if it has spread to several locations, there usually isn't a clear benefit to doing it, and chemo or other systemic therapies are the main treatment approach...she'd have a right to say no to those, but that doesn't mean that other options are appropriate as an alternative.

Of course, it's most important to determine what the PET scan shows and what the doctors there suggest. We can certainly try to help more once you have more information to work with.

Good luck.

-Dr. West

clemclem44

Ok. Well it sounds like it's more useful to understand all the locations of the cancer rather than what kind. Since it had spread to the N2 nodes and she didn't do chemo I suppose this is somewhat likely - that it's the same cancer.

I never can tell if my signature is listing off all the stats about my mom so just in case it's not here's her history:

Mom 61 yr old w. systemic lupus;42 yr smoker; 2x breast cancer survivor 26yrs (treated with rad both times); Spot found too small to biopsy 5/2010. Follow up scan confirms growth; Biopsy 2/8/2010 confirms Aednocarcinoma w. N1 involvement. Surgery 3/8 & 3/14, rt. upper lobectomy, then 4cm more of middle lobe due to N2 involvement. Stages IIIA. Chemo not recommended due to health issues-Rad not possible due to previous Rad tx. Monitoring only. 10/2012: spot on chest x-ray discovered. Follow up PET shows spot and additional location in "throat"; Bioposy scheduled 10/31 and results due 11/2.

My mom is terrified of Chemo. and the value added post op with this last cancer didn't justify the attempt. I tried to talk her into just trying it. But we were also cautioned that if we started and couldn't finish the full 4 treatements (i think it was 4) then it would be like she never did it at all.

The woman has absolutley no reservations about going under the knife though. I'll follow up with the results once we get them at the end of the week. Thanks again for your input and support.

clemclem44

Spoke to my mom last night and she sounds better than I thought. They only did the biopsy of the spot in her throat. She admitted that she was coughing up blood. I think they plan to biopsy the other spot that orginally showed in the chest x-ray on Nov. 16th. I didn't ask too many questions and wonder why the delay in the biopsy - maybe it's more complicated and I guess in the big picture one spot of cancer back is just the same as 2?

This would be the first time though that she openly seemed OK with Chemo, which is what they are preparing her for. Sounds like the biopsy was more of a formality than anything - and I think we all felt that way a bit.

So she gets the results of the biopsy probably early next week and it seems I'll be on the stage IV board then. I'm thankful that she was open about chemo - as I was just terrified that she would give up the fight and I'd loose her too fast.

With this being her 4th brush with cancer and her first time having chemo I have no idea what to expect. Once I know more about her official dx then I'll want to better understand different treatment options for her. Should they be testing the tumor for anything? She is a smoker - still is a smoker :-x but I want the right drugs on board to stall these tumors growth and with any luck slightly shrink them.

I am also thankful that she says she doesn't have any symptoms other than the blood. No pain or overly persistent cough. So I feel like that is a good thing.

I'll post on the Stage IV board once I get all the info next week. And thanks again everyone. Without this place I'd be freaking out in cyberspace... this is just so overwhelming and there is so much information you can search for out there - it's nice to have a conversation about it.

Dr West

If the biopsy shows non-squamous NSCLC, it would be quite appropriate to test for an EGFR mutation and ALK rearrangement, as detecting either of these would change the treatment plan to favoring a targeted therapy (Tarceva or XALKORI, respectively) rather than initial chemotherapy. However, if the biopsy is being done now, you'll get the biopsy results and then have tissue for these studies if it proves to be advanced NSCLC, as expected.

Surgery in the setting of metastatic NSCLC is rarely a helpful intervention, and it would be even less likely to be helpful if the cancer has spread to additional locations. So in that sense, while having one metastatic lesion might be considered like being "a little pregnant" (you either have metastatic NSCLC or you don't, without a real spectrum), we sometimes make exceptions for a single focus of disease that really wouldn't make sense if there is more than one area of viable metastatic cancer. It does sound like a systemic approach would be most indicated here.

Good luck.

-Dr. West