Stage 2/3 Rectal Cancer Scan Question/Results

[MassMike]

Hello everyone,

My mother was diagnosed with Stage 2/3 rectal cancer in August. She completed her neoadjuvant chemoradiation regimen in October and has surgery scheduled for 12/12. On her initial scans, there were some findings but the doctors did not find them suspicious as my mother was a smoker for 35 years before quitting 6 years ago, and she had bronchitis/pneumonia constantly when she was younger. The radiologist said that since there were lung nodules found, although not suspicious there should be follow up scans in 3 months. It’s been 3 months and my mother’s doctors have said that since surgery is scheduled, the tumor shrunk noticeably, and nothing would change there is no need to do scans at this time and they would follow up with scans after surgery. Is this normal to just go ahead and follow through with surgery without scans? I’m going to post the reports that were on my mothers scans and if anyone has any knowledge of anything regarding them I would appreciate any insight you may have. Thank you so much:)

FINDINGS:
3 x 7 mm nodule along the right minor fissure image 48 may represent an incidental intrapulmonary lymph node. 4 mm micro nodules right upper lobe image 30 and left apex image 12. additional scattered less than 4 mm micro nodules. No suspicious lung
nodules or consolidative changes. Central airways are patent. No pleural effusions.

Hepatobiliary: Subcentimeter hypodense focus medial aspect of left lobe, too small to characterize, likely simple cysts. Status post cholecystectomy. No intra or extrahepatic biliary ductal dilatation.

[Lee]

Hi Mike and welcome. Sorry for the reason you are here.

I'm a bit confused. How many scans has your mother had? One or more? Or are they comparing it to a scan prior to her diagnoses?

I had a CAT scan just prior to my surgery, I believe that is normal procedure so am a bit confused with her Dr. saying after surgery? And if it was recommend to do follow up scan in 3 months, I do believe there should be follow up scan.

What kind of Dr. is treating her? Oncologist?

Has her Dr. mentioned anything about a PET scan?

Good luck,

Lee

[MassMike]

Hi Mike and welcome. Sorry for the reason you are here.

I'm a bit confused. How many scans has your mother had? One or more? Or are they comparing it to a scan prior to her diagnoses?

I had a CAT scan just prior to my surgery, I believe that is normal procedure so am a bit confused with her Dr. saying after surgery? And if it was recommend to do follow up scan in 3 months, I do believe there should be follow up scan.

What kind of Dr. is treating her? Oncologist?

Has her Dr. mentioned anything about a PET scan?

Good luck,

Lee

My mother had scans when she was first diagnosed to see if it’s spread, and nothing since then. Her oncologist said that it isn’t necessary to do scans at this time because they’re going to go ahead with surgery regardless and evaluate everything after, and her surgeon agreed. Her doctors are excellent and I trust them, it just seemed odd.

[NHMike]

Hello Mike,

I had similar concerns - could the cancer spread in-between chemo/radiation therapy and surgery or after surgery but before adjuvant chemotherapy. I talked it over with my oncologist and he said that he could order scans but that it could potentially delay the surgery if something were found. I suspect that you could get scans if you pushed the right doctor to get them. But what difference would that make for treatment? Would you cancel the surgery to go after the mets?

michael (in NH)

[heiders33]

I did not have any scans done prior to my surgery. My surgeon said he did not need them - he did a physical exam to see what my response was to chemo/radiation. I haven’t had a scan since DX and won’t get another one until post-adjuvant chemo. So I don’t think it’s necessarily standard procedure, unless my surgeon is just crazy!

[MassMike]

Hello Mike,

I had similar concerns - could the cancer spread in-between chemo/radiation therapy and surgery or after surgery but before adjuvant chemotherapy. I talked it over with my oncologist and he said that he could order scans but that it could potentially delay the surgery if something were found. I suspect that you could get scans if you pushed the right doctor to get them. But what difference would that make for treatment? Would you cancel the surgery to go after the mets?

michael (in NH)

I’ve been following your story for a while, hence my name. I’m in Massachusetts, mothers being treated at Lahey Clinic in Burlington. We were considering MGH or Dana Farber, but they were both still quite far and Lahey has been excellent.

[Lee]

Hello Mike,
. . . he said that he could order scans but that it could potentially delay the surgery if something were found. . .
michael (in NH)

Okay, I see that procedures are changing. When I was diagnosed, I was scanned at diagnoses. Did radiation and was scanned again just prior to surgery. Standard protocol in those days. When I had to change Oncologist, new Oncologist wanted a PET/CAT scan as that was standard procedure for new patients.

Thanks for teaching me something new today,

Lee

[susie0915]

I did have a pet scan after chemo/radiation. I also had a ct scan at diagnosis. My next ct scan wasn't until a month after I finished treatment. Idk maybe there are different protocols doctors follow.

[Aqx99]

I was scanned at diagnosis, scanned again after chemoradiation and will be scanned again when chemo is over, before my reversal surgery. I don't think it is unreasonable to ask for another scan. I have 2 nodules in my lungs that we are watching, which so far have been unchanged.