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 Post subject: Hypermetabolic activity
PostPosted: Thu Aug 21, 2008 10:13 am 
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Joined: Sun Oct 28, 2007 2:00 pm
Posts: 59
I just spoke with mom's oncologist and Pulmonary specialist yesterday about the cloudiss on her Pet scan, and wanted to clarify whether is was radiation pneumonitis or not. And I am very sad right now. The onc suspected radiation pneum, but she said she could not say 100% that it wasn't a return of the cancer. The pulm doc said that scan showed "hypermetabolic activity" on the left lung, where the original cancer was found. He said he doesn't like the looks of it and wants to do a broncoscopy. He thinks it's cancer. My mom must be in denail, because she refuses the bronc at this time.

She has symptoms that could go either way. Coughing, and weight loss being the main ones. The onc prescribed 10 more days of steroids to see if that would help her symptoms. The pulm doc didn't like that. He said that it's not" good medicine" to prescribe drugs for an unknown condition.

The onc seemed so sure that it was just inflammation.

Hypermetabolic activity doesn't sound good. I wonder what happening inside there. I just wish someone knew, without the bronc. They will do another scan in 2 months to see if anything changed. I just wonder if that's too long to wait.

I feel like a jerk right now. Like how could I believe that the cancer could be gone so easily? Like, it was too good to be true. I feel like we're starting all over again. And the worst part is that my mom lives in a very dirty house with a man who chain smokes right in her face. How can anyone heal in that environment?

Any wise words or experiences would be appreciated. thanks!

Mom was a 2 pack a day smoker. 65 years old. Persistent cough, stomach ache and back pain lead her a new doc..
Aug 2007- Lung x-ray shows large tumor on left lung.
Sept 07- attempt broncoscopy, but mom won't tolerate.
Needle biopsy is done to get lung sample. Lung collapses. Tests show it's small cell lung cancer, limited. Moms quits smoking. Mom is 65. Inoperable because it's on an artery. Lung was partly collapsed for a while!!.
Oct 07 starts concurrent radiation to lung and chemo. Cistplatin and episotope. 3 days on, 4 weeks off.
Side effects- low wbc. Needed shots to boost. Hair loss. Nausea, fatigue.
35 doses of radiation.
Nov 2007- Another round of cistplatin and epistope
Side effects-low wbc, fatigue and nausea. Mom's scalp seems burnt. Onc switches chemo to carboplatin.
Nov Ct Scan shows tumor shrunk 50%.
Dec 2007-Carboplatin and etoposide. Mom seems better with the new chemo. No infections, no hospitalization.
Wbc 2. CT scan finds no cancer. Mom goes camping!
Jan-March 2008- finish up chemo and Ct scan shows no cancer.
April 2008 PCI for 4 weeks (20 doses).
March 2008 ALL DONE!!
Mom tolerates all treatment well. Has some hearing loss due to PCI.
April 2008 Pet/Ct Scan confirms Complete responder.
(Mom celebrates by starting to smoke again.)
May- Mom was there to see the birth of my third child! Mom turns 68.
May/June 2008 Cough develops
July 08- Pet/CT Scan shows some cloudiness on left lung. (original problem spot) Onc thinks it's iradiation pneumoitis. prescribes steroids. Refers to Pulmonary doctor.
Pulmonary doctor thinks we need to do a broncoscopy to see if there is residual cancer cells. Says there is cloudiness and hypermetabolic activity. Mom refuses.
Aug 2008- Onc prescribes steroids to see if coughing symptoms go away.Also prescribes Lexapro for depression. Works good!
Oct 2008- Mom is still taking low dose steroids. Still coughs a little. Waiting for new CT scan in Dec. Halloween is one year since first chemo. Her hair is growing back nicely. Se is doing well.
Dec 2008- mom's CT scan showed a "shadow" on the original lung, in the same spot. Here we go again. Depression sets in big time.
Jan 2009- PET scan w/ contrast. Waiting on results.
Jan 22,2009 Broncoscopy. Results are negative.
July- Ct scan and Pet show some new activity. Needle biopsy to the lung show small cell.
July 16th, 2009 Mom starts new chemo -Topeketan . Once a week.
She feels sick and nauseated, no other side effects so far.
November 20th, 2009-Stopped taking chemo. Side effects include nausea, hair thinning, weight gain, muscle weakness.
CT scans shows no growth or shrinkage. Taking a break from chemo over the holidays.
Jan 2010-mom stops Topectan for three weeks. Has Pulmonary Embolism, admitted to hospial for three days. Blood thinners and leg filter inserted for futers clots.
Feb 2010- CT scan shows growth. Taxotere to start next week. happy Valentines Day.

 Post subject:
PostPosted: Thu Aug 21, 2008 11:38 am 

Joined: Wed Feb 05, 2003 8:45 am
Posts: 1621
Location: maryland
the hypermetabolic activity could be caused by pneumonitis.

Unfortunately, the broncoscopy can also be inconclusive.

Has another CT scan and x-ray been done?

I would ask the Dr what is the percentage of the broncoscopy being accurate

Also endoscopic ultrasound-guided fine needle aspiration is sometimes used (don't know if it is applicable in your mom's case)

Maybe a fused PET-CT scan can be done. It is a pet scan and a CT scan done at the same time. This can pin point where the hypermetabolic region is and if it matches what is found on the CT

I am not a Dr, best to ask as many questions as possible and it never hurts to get a 2nd opinion

Mother Stage I clinically, Stage IIIa pathologically. Large cell neuroendocrine carcinoma. Deceased March 2003
Please seek 2nd opinions and verify everything

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