I will start with the fact that Tom is a 3 year stage 4 lung cancer survivor. The latest PET results from Friday have me worried though and I looking for opinions. We have a routine follow up appt with the Onc on 2/15 and are thinking of calling in the morning to move it up. The Pulm did not seem to like that that appt was still 3 weeks away.

The PET was ordered by the pulmonologist after a routine CT was marred by a bad case of pneumonia which landed Tom in the hospital for 5 days last month. The CT showed that the right hilum could not be evaluated due to the consolidation in the right lung from the pneumonia. The Pulm says to talk to the Onc and see if he thinks another round of chemo is warranted.

Findings show:
There is minimal faint increased activity associated with the soft tissue attenuation in the right hilum, SUV value less than 3. Although evaluation is limited without intravenous contrast, the soft tissue densities in the right hilum have increased by about 1 cm, superiorly presently measuring 3 x 4.7 cm compared to the prior 3 x 3.7 cm, and in the right infrahilar distribution presently measuring about 2.2 x 3.7 cm compared to prior 2 x 2 cm.

Impression:
Slightly more prominent soft tissue attenuation within the right hilum, but SUV values are less then 3. Findings are nonspecific, low to moderate suspicion for malignancy.
Very close CT surveillance of the chest is recommended.

Any insight would be appreciated.

Thanks,
Denise

_________________
[color=green]Tom 77 yrs young, Devoted Wife of 20 yrs Denise age 49 yrs, 6 kids, 5 granddaughters, 2 grandsons [/color]
__________________________________
[color=blue]1/29/08 Diagnosed with Stage IIIA NSCLC Squamous Cell with lymphnode and liver involvement.
1/29/13 - 5 Year survivor!!
1/29/12 -4 years Survivor!!
2/11/08 - 7/16/08 7 rounds of chemo w/ Carbo/Taxol
3/24/08 Restaged at IV.
4/28 CT Scan
5/5 Results day / Great scan w/ overall shrinkage.
5/12 MRI scheduled.
5/20 - Rad consult
5/28 - 7/16 Radiation to chest 35 rounds
8/18 - CT shows the lung tumor is down to 3.7cm x 2.7cm and liver lesion is GONE!! No signs of metastatic disease within the abdomen. No further treatment need at this time. Next scan in 3 months.
12/5 Hospitalized with pneumonia
12/6 CT Scan all clear. Tumor continues to shrink.
12/10 Home on 24/7 Oxygen. SOB continues.
5/18/09 PET SCAN ALL CLEAR!!!
5/2010 NED!!
4/2012 NED!!
10/2012 CT = Mixed bag of nuts
[/color]

[color=purple]Don’t be afraid your life will end, be afraid that it will never begin. [/color]

[color=red]READ TOM'S STORY @ [/color]
http://www.lungevity.org/l_community/viewtopic.php?t=37425

I don't know if this is an immediate worry....to my untrained eye it looks like there is cause for suspicion of growth but the changes are slight and they suggest watching it carefully.....if it were me I'd try to get in sooner to see if they should retest with contrast just to be certain instead of the watch and wait...but I'm not a medical professional and I've never had any patience.

I think asking Jack over at GRACE to see if maybe he had any insight into next steps might help to answer some of your questions until you get into the onc.

Idk, 3 weeks may not be a difference maker in this case and watch and wait may be the only thing they can do... call the Dr. and hear what he has to say- might put your mind at ease.

I hope you can get in sooner and get some questions answered. Until then, I'm keeping Tom and you in my prayers.

(((hugs)))

_________________
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15 yr cancer survivor.

"Any of us who have experienced the cancer journey- and survived it-
have an obligation to make the path clearer and aid those that come after us."
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In memory of Jessee Dewey, SCLC
December 29, 1938 - September 6, 2003
Lisa Dewey- Jan. 22, 2007
my parents are together in heaven


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My first thought was like Katie - ask over at Cancergrace.org. Seems suspicious that this follows a bout of pnemonia - there is usually some "swelling" and "activity" during a recovery period. Seems to me that they should redo the PET with contrast after a short recovery period (couple of weeks). The low SUV numbers as stated still indicate some activity and warrant another look as the doctor suggested. Like always it seems to be a piece of "hurry up and wait" - but we all know that patience gets us nothing here - I would try and get them to follow up the PET and check the SUV numbers since the doctor is already technically recommending another round of treatment.
Annette

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5/5/09 Bad Cough - sent for xray
5/6/09 CAT SCAN
5/8/09 Pulmonologist - not good ordered bronch
5/14/09 Bronc 5/19/09 Breathing test & Results - NSCLC (Adenocarcinoma 3cm)
5/22/09 PET Scan - 5/27 referred to surg & onc
6/2/09-met with surg & onc. They say there are two spots. One small on left lung and one larger one on right lung 3.6 x 3.2 cm - they are pretty sure and approaching it as if it were two separate cancers staging the right at II and the left at I.
June 15 - RML removed - Pathology - margins clear and nodes clear. June 25 follow up with surgeon - doc agreed to stage I since it appears he got it all - June 30 return to work
July 7 Oncologist says Stage 1A - we don't recommend chemo for this stage
Aug 17 - surgery - again took ULL and some nodes -
Sep 8 to onc - Both sides IA - no chemo just watch closely
Dec 15, 2009 - CT Results - NED
March 10th, 2010 - CT Scan - Results - NED
June 15th, 2010 - XRay - Results - NED
Sep 15th 2010 CT Scan - Results - NED
Dec 2010 XRay Only - Results - NED
Dec 2010 MRI - Results - Clear
March 2011 - CT Scan - NED
June 2011 - XRay Only - NED
Sept 2011 - Scan & Vampires - Scared to death!!!!

I think I agree with Annette and Katie too. 3 weeks seems like such a short amount of time, and yet it's not if you are worried about new growth. I was curious of the PET results that followed the CT.

I think you'll get sound medical advice at cancergrace too.

MI Judy

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6/07 DX NSCLC, Left Upper Lobe wedge resection: Stage 2.3/4, (2B?) Adenocarcinoma, measures 2.5x1.5x1.1cm. Involving visceral pleura but not through it. 5 rounds chemo, carboplatin and Taxol. Subsequent scans NED.

1/11 3.5 mm node found. 10/11 CT node now 8 mm, and new 6 mm node. 11/11 CT Pet shows slight uptake. 1/4/12 Biopsy - Pneumothorax complication. 1/14/12 Lobectomy of upper rt. lobe. NSCLC Adenocarcinoma in situ, nonmucinous (bronchioloalveolar carcinoma) 1.4cm involves pulmonary parenchyma.
3/14/12 Begin 4 cycles of Cisplatin/Navelbein, with Neulasta shot
4/6/12 Chemo changed to Carboplatin/Navelbine without Neulasta shot. Reduced chemo by 50% due to intolerance.
7/5/12 CT scan is clean, NED for lung cancer! There are issues with liver and stomach that will be investigated but not believed to be because of cancer. Wait and see!

*Avatar was taken 7/3/12 on our way out to see the Fireworks on a friends boat on their lake!

Mom dx SCLC 1/96, passed 10/19/96, age 62
Dad dx Brain cancer 4/87, passed 6/87, age 57
Sister dx Brain cancer 4/83, passed 12/83, age 25