metastatic node left hemipiaphram - 1264700

Tue, 07/01/2014 - 12:33

NSCLC adenocarcinoma Wife
July 2012 Lower Left Lobe removed Cancer Free
August 2013 Metastic to Midstinum
December 2013 Rad/Chemo complete, Cancer free Started Avastin and Alimta Maint.
March Pet cancer free, radiation fibrosis
June Pet Scan: Development of a metabolically active prominent lymph node within the epicardial fat on the left insinuating ventrally to the anterior aspect of the left hemidiaphragm. Node measured 0.9cm, SUV 5.6. This lymph node is retrospectively identified on the previous examination, but appeared smaller, without appreciable activity on the prior exam. This is compatible with metastic lymphnode.

What exactly does this means. We were told stop maint. and xray monthly or continue maint. and wait for next pet in 3 months. If enlarges change regimen. Thank you and god bless, Bill Urban Husband

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Hi Bill, I'm so sorry your wife has lung cancer. It seems like the best one can do so early on is wait, watch and see. However I don't know how that applies with a stop in treatment and surveillance with x rays. x rays are an especially low quality compared to CT scans which are used almost exclusively by lung cancer specialists to watch how cancer reacts.

It's impossible for a doctor not involved in a case to know exactly why another doctor makes certain treatment decisions. I'll ask a doctor to comment though it's only possible to know what is meant by asking the doctor who said or wrote it.

All best,

Dr West

I'm also very sorry about her diagnosis and the recent concerning findings.

Janine is exactly right that the best way to know what the doctor is thinking is to ask her own doctor directly. However, from what you've conveyed, the imaging result suggests that there is likely progression of her cancer in an isolated area, for which if there is more conclusive evidence of progression, whether by repeat x-rays or a later PET scan, it will lead to the conclusion that it's time to try an alternative approach, because the findings will show that the cancer is resistant to the current treatment strategy.

Good luck.

-Dr. West


Thank you so much for a response. She tolerates the maint well. Until we have more conclusive evidence should she stop the maint or wait and transition with a new strategy .Thank you all so much, you all are so valued with your work, but especially with your prompt clarity in communication. Bill Urban