My post chemo CT- looks scary, doc says I am ok

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TXLiz
Posts: 249
Joined: Thu Sep 22, 2016 3:31 pm

My post chemo CT- looks scary, doc says I am ok

Postby TXLiz » Fri Apr 21, 2017 9:25 pm

Got my first scan after chemo. Wasn't too worried until the night before. Onc said I am currently NED, but the CT report seems scary. If you have any insight please chime in. Thank you all again for your kindness and expertise. I'd be lost without it.

"FULL RESULT:

Examination: CT CHEST ABDOMEN PELVIS W CONTRAST, 4/16/2017 12:10 PM

Clinical History: Malignant neoplasm of cecum

Indication: colon cancer

Comparison: 08/26/2016

Technique: CT of the chest, abdomen, pelvis was performed with intravenous contrast.

Findings:
No significant supraclavicular, mediastinal or hilar adenopathy is evident

There are prominent but nonspecific axillary nodes.

No pulmonary nodules or masses are seen to suggest metastatic disease.

The liver contains a hypervascular focus in segment 4 adjacent to the middle hepatic vein on image 96 series 3 which is felt most likely to represent a regenerative nodule or focal nodular hyperplasia. This measures approximately 1 cm

Spleen is unremarkable. A small cyst is noted in the lower pole of the spleen on image 181 of series 3 and in the midpole on image 162 of series 3.

Adrenal glands and pancreas are unremarkable.

There is been a prior cholecystectomy.

Both kidneys function without evidence of hydronephrosis.

There is been a right hemicolectomy and ileocolic anastomosis.

There is mild stranding identified along the course of the ileocolic vessels (image 200 of series 3 and 196 of series 3), this is currently a nonspecific finding.

No intra-abdominal ascites is evident."
Vomiting and blockage 9/19/16 46 y F
R hemi colectomy 9/20/16
Stage 3 B CRC, located in cecum
3 out of 16 lymph nodes positive
perineural invasion/lymphovascular invasion
infiltrating, mod differentiated adenocarcinoma with a mucinous component
separate tumor nodules present in pericolonic adipose tissue
MSI-high
Baseline PET scan clear 9/16 CEA 0.5
FOLFOX 10/16- 3/17
April 16th, CT scan clear. CEA 1.1
Lynch "inconclusive"
Colonoscopy 10/5/2017 clear

rp1954
Posts: 1853
Joined: Mon Jun 13, 2011 1:13 am

Re: My post chemo CT- looks scary, doc says I am ok

Postby rp1954 » Sat Apr 22, 2017 3:27 am

I believe in getting all the data, including extra blood data.

Successful continuous treatment means we cannot see the mets on CT, PET, MRI yet after several years, but we can see the blood markers rise alarmingly when some treatments get missed or slide. Some markers are low for years and then rise as cells adapt, or parts of the treatment change. CEA alone would be a crash and burn for us.
watchful, active researcher and caregiver for stage IVb/c CC. surgeries 4/10 sigmoid etc & 5/11 para-aortic LN cluster; 8 yrs immuno-Chemo for mCRC; now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher, peaking ~2011-12, taper chemo to almost nothing mid 2018, IV C-->2021. Now supplements

Swirdfish
Posts: 290
Joined: Sun Jun 19, 2016 3:57 am

Re: My post chemo CT- looks scary, doc says I am ok

Postby Swirdfish » Sat Apr 22, 2017 5:56 am

Looks ok to me
06/2016 Went in for colonoscopy came out with a tumor. Age 35
12cm from verge at junction. Rectal cancer.
Clinical stage T3 NO MO
Temp illestomy
Completed 5FU and Radiation
LAR surgery planned 13 Oct 2016
Completed ULAR surgery 11-10-2016.
0/22 nodes
pT3 N0 M0 R1
Stage 2A

Pathology reviewed and changed
ypT3 N0 M0 R0

Started folfox 21-11-2016
5-4-17 NED
Reversal 12-4-17

zx10guy
Posts: 233
Joined: Mon Jan 07, 2013 12:54 pm

Re: My post chemo CT- looks scary, doc says I am ok

Postby zx10guy » Sat Apr 22, 2017 8:21 am

Seems like everything is ok. Did you copy and paste all of the report verbiage here? The impressions section is missing. Every radiology report I've had and seen has an impressions section where the radiologist summarizes what he/she found and makes any additional diagnostic recommendations. For example, my recent PET/CT was ordered because of my high CEA levels to check for recurrence/metastasis. The radiologist went through each section of my body and listed his observations just like what your report showed. At the end, the radiologist had an impressions section which said nothing was found and there was no signs of metastasis/recurrence.

Other CTs I've had for a while had the radiologist make a comment about the two liver lesions found since my diagnosis. For a while the radiologist kept recommending followup via MRI/ultrasound to rule out those lesions being tumors. None of that was done because at diagnosis, a PET was done where these sites didn't light up and a biopsy was done during my resection procedure to definitively rule it out. Because I've had a bunch of CT scans since then and the size of the lesions haven't changed, the radiologist only makes a note about the lesions in the findings sections and doesn't even mention it anymore in the impressions section.

radnyc
Posts: 446
Joined: Tue Apr 06, 2010 6:32 pm

Re: My post chemo CT- looks scary, doc says I am ok

Postby radnyc » Sat Apr 22, 2017 8:35 am

Your scan is fine. Try not too worry, CT scanners are getting better and pick up things that are benign all the time these days.
DX Jan 2010, at age 47
Feb - colon resection - 2/17 nodes positive
April - liver mets - Stage 4
3 months Folfox chemotherapy
August '10 liver resection and HAI pump
7 months chemo FUDR HAI and Folfiri systemic
NED since August 2010
Last treatment April 2011
HAI Pump removed Dec 2015

TXLiz
Posts: 249
Joined: Thu Sep 22, 2016 3:31 pm

Re: My post chemo CT- looks scary, doc says I am ok

Postby TXLiz » Sat Apr 22, 2017 3:11 pm

"This is a initial postoperative study and will serve as a baseline for subsequent follow-up. There are postoperative changes related to right hemicolectomy and ileocolic anastomosis. At the current time no metastatic disease is evident. There is mild stranding identified close to the site of ileocolic anastomosis which is nonspecific and can be followed on subsequent scans."

"Narrative
FULL RESULT:

Examination: CT CHEST ABDOMEN PELVIS W CONTRAST, 4/16/2017 12:10 PM

Clinical History: Malignant neoplasm of cecum

Indication: colon cancer

Comparison: 08/26/2016

Technique: CT of the chest, abdomen, pelvis was performed with intravenous contrast.

Findings:
No significant supraclavicular, mediastinal or hilar adenopathy is evident."

I left this portion out before, in part, I think.

Thank you all so much for your opinions and replies. I know the folks here have great experience and knowledge about such things, and hearing from you all is such a wonderful resource.
Vomiting and blockage 9/19/16 46 y F
R hemi colectomy 9/20/16
Stage 3 B CRC, located in cecum
3 out of 16 lymph nodes positive
perineural invasion/lymphovascular invasion
infiltrating, mod differentiated adenocarcinoma with a mucinous component
separate tumor nodules present in pericolonic adipose tissue
MSI-high
Baseline PET scan clear 9/16 CEA 0.5
FOLFOX 10/16- 3/17
April 16th, CT scan clear. CEA 1.1
Lynch "inconclusive"
Colonoscopy 10/5/2017 clear


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