PET scan not good :(. Anybody's surgeon was able to find a 8mm lung nodule via VATS?

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lovelife789
Posts: 97
Joined: Thu Aug 24, 2017 5:28 am

PET scan not good :(. Anybody's surgeon was able to find a 8mm lung nodule via VATS?

Postby lovelife789 » Wed Jul 04, 2018 6:52 pm

So I did my PET scan and it came back that a stable 5mm nodule that has always been there in my RLL (almost at the far right tip) since my first PET has grown to 8mm with SUV uptake 3.06 :evil: . Dr said it can be a lung met or a primary (it did not respond at all to FOLFOX).

I am now referred to a thoracic surgeon, we are now debating whether he will be able to locate that 8mm nodule via VATS or should we just wait til it grows a bit to be more identifiable. But the "letting it grow" idea frightens me... :(

The Dr said he can't be 100% sure it's cancer but since it has SUV uptake, it's very likely :cry: :cry:

Anybody has had VATS with 8mm metabolic nodule? Or has anybody found out after VATS it's actually not cancer?

I'm a bit disappointed but not devastated ... At least the oncologist said either it's a primary or met, usually with this size they don't really suggest starting chemo... :cry:

Any sharing is appreciated!
Last edited by lovelife789 on Wed Jul 04, 2018 10:38 pm, edited 1 time in total.
F/38 - Dx 8 Mar 17, CEA 80.5
Stage IV Sigmoid Colon, 6 Liver mets, T3N0M1a, KRAS NRAS Wild, G2=Moderately differentiated
3/17- 6/17 - 6 rounds of FOLFOX + Erbitux - CEA 2.5
7/17- 8/17 - 2-stage Liver Resection/Colon/Gall, all clear margin
8/25 - CEA 0.7
9/11 - Started Adjuvant chemo Xelox
9/15 - Intense reaction to Xeloda, it was dropped
9/22 - Folfox resumed, severe allergic reaction to Oxi
11/17 - Clear MRI
12/17 - completed a total of 13 rounds of FOLFOX
1/18 - Clear PET SCAN
3/18 - Clear MRI

Detox
Posts: 23
Joined: Fri Apr 28, 2017 5:27 pm

Re: PET scan not good :(. Anybody's surgeon was able to find a 8mm lung nodule via VATS?

Postby Detox » Wed Jul 04, 2018 8:19 pm

Did you take a preoperative CEA or is CEA a good indicator for you? I heard CEA can be elevated for lung metastasis.

lovelife789
Posts: 97
Joined: Thu Aug 24, 2017 5:28 am

Re: PET scan not good :(. Anybody's surgeon was able to find a 8mm lung nodule via VATS?

Postby lovelife789 » Wed Jul 04, 2018 10:37 pm

Detox wrote:Did you take a preoperative CEA or is CEA a good indicator for you? I heard CEA can be elevated for lung metastasis.


I did. CEA is a good indicator for me. But it has stayed at 1.0 for a few months and in most recent two months, it even went down to 0.7... so this PET scan result surprised me a bit.
F/38 - Dx 8 Mar 17, CEA 80.5
Stage IV Sigmoid Colon, 6 Liver mets, T3N0M1a, KRAS NRAS Wild, G2=Moderately differentiated
3/17- 6/17 - 6 rounds of FOLFOX + Erbitux - CEA 2.5
7/17- 8/17 - 2-stage Liver Resection/Colon/Gall, all clear margin
8/25 - CEA 0.7
9/11 - Started Adjuvant chemo Xelox
9/15 - Intense reaction to Xeloda, it was dropped
9/22 - Folfox resumed, severe allergic reaction to Oxi
11/17 - Clear MRI
12/17 - completed a total of 13 rounds of FOLFOX
1/18 - Clear PET SCAN
3/18 - Clear MRI

User avatar
Atoq
Posts: 264
Joined: Wed Oct 25, 2017 9:31 am

Re: PET scan not good :(. Anybody's surgeon was able to find a 8mm lung nodule via VATS?

Postby Atoq » Thu Jul 05, 2018 2:15 am

I had a 8 mm nodule that was removed last week via VATS. We also did core needle biopsy after positive PET scan, to determine whether it was a primary tumor or a metastasi.

It was then 1 cm in diameter. It is safe to let it grow if it is from CRC, because this type of metastasis grow slowly and do not produce new metastasis.

We waited three months from PET scan to remove it. The surgeon needs to feel the nodule with the fingers in order to locate it. While biopsy is done with CT. Mine was in the lower lobe, close to the edge.

Claudia
45 year old, mother of 2
Dx rectal cancer October 2017
At least T3N2aMX (suspect metastasis to one lung 8 mm)
Lynch negative
Neoadjuvant chemoradiotherapy Xeloda + 25x2 Gy
05.12.17 laparotomic surgery for blockage, colostomy
25.01.18 laparotomic lar, hysterectomy, ileostomy
05.03.18 core needle biopsy of lung, updated to stage IV
07.05.18 CAT scan, lung metastasis 11 mm
04.06.18 ileostomy reversal
26.06.18 wedge VATS surgery

lovelife789
Posts: 97
Joined: Thu Aug 24, 2017 5:28 am

Re: PET scan not good :(. Anybody's surgeon was able to find a 8mm lung nodule via VATS?

Postby lovelife789 » Thu Jul 05, 2018 7:50 am

Atoq wrote:I had a 8 mm nodule that was removed last week via VATS. We also did core needle biopsy after positive PET scan, to determine whether it was a primary tumor or a metastasi.

It was then 1 cm in diameter. It is safe to let it grow if it is from CRC, because this type of metastasis grow slowly and do not produce new metastasis.

We waited three months from PET scan to remove it. The surgeon needs to feel the nodule with the fingers in order to locate it. While biopsy is done with CT. Mine was in the lower lobe, close to the edge.

Claudia


My case is almost exactly the same! Mine is at the lower right lobe, at the very end of the edge. So the core needle biopsy successfully identify that's a met? I also wonder why lung mets are not usually responsive to chemo. I saw many people here did chemo while having a small <1cm met and it just stays there.

Did you have an elevated CEA prior to that met growing? My CEA even went down further ...as the nodule grew..

Did they tell you what follow up treatment did they plan or anything after VATS?

I feel a bit better after reading your reply. I remember there was a thread all about lung mets... I can't find it now... Hmmm
F/38 - Dx 8 Mar 17, CEA 80.5
Stage IV Sigmoid Colon, 6 Liver mets, T3N0M1a, KRAS NRAS Wild, G2=Moderately differentiated
3/17- 6/17 - 6 rounds of FOLFOX + Erbitux - CEA 2.5
7/17- 8/17 - 2-stage Liver Resection/Colon/Gall, all clear margin
8/25 - CEA 0.7
9/11 - Started Adjuvant chemo Xelox
9/15 - Intense reaction to Xeloda, it was dropped
9/22 - Folfox resumed, severe allergic reaction to Oxi
11/17 - Clear MRI
12/17 - completed a total of 13 rounds of FOLFOX
1/18 - Clear PET SCAN
3/18 - Clear MRI

stu
Posts: 711
Joined: Sat Aug 17, 2013 5:46 pm

Re: PET scan not good :(. Anybody's surgeon was able to find a 8mm lung nodule via VATS?

Postby stu » Thu Jul 05, 2018 10:17 am

Hi,
My mum had one removed at 7mm with uptake .
Surgeon did a good job at removing it . It was cancer and no further problems experienced . All part of the original spread apparently . Just took seven years to show its face .
Hope it all goes well for you .
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared

Lee
Posts: 5594
Joined: Sun Apr 16, 2006 4:09 pm

Re: PET scan not good :(. Anybody's surgeon was able to find a 8mm lung nodule via VATS?

Postby Lee » Thu Jul 05, 2018 10:24 am

Don't really have any advice, just want to wish you good luck. Sorry this is happening to you.

Good luck,

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!

User avatar
Atoq
Posts: 264
Joined: Wed Oct 25, 2017 9:31 am

Re: PET scan not good :(. Anybody's surgeon was able to find a 8mm lung nodule via VATS?

Postby Atoq » Thu Jul 05, 2018 11:11 am

lovelife789 wrote:
My case is almost exactly the same! Mine is at the lower right lobe, at the very end of the edge. So the core needle biopsy successfully identify that's a met? I also wonder why lung mets are not usually responsive to chemo. I saw many people here did chemo while having a small <1cm met and it just stays there.

Did you have an elevated CEA prior to that met growing? My CEA even went down further ...as the nodule grew..

Did they tell you what follow up treatment did they plan or anything after VATS?

I feel a bit better after reading your reply. I remember there was a thread all about lung mets... I can't find it now... Hmmm


Yes, the core needle biopsy identified the type of cells as coming from the colon/rectum, not from the lungs. My CEA has always been normal.There will be only scans now and no more chemo as long as no more metastasis show up. But I am in Norway, protocols might differ from your country. Not growing is already a response to chemo according to my oncologist, but I agree mine changed very little also after neoadjuvant chemo.

Claudia
45 year old, mother of 2
Dx rectal cancer October 2017
At least T3N2aMX (suspect metastasis to one lung 8 mm)
Lynch negative
Neoadjuvant chemoradiotherapy Xeloda + 25x2 Gy
05.12.17 laparotomic surgery for blockage, colostomy
25.01.18 laparotomic lar, hysterectomy, ileostomy
05.03.18 core needle biopsy of lung, updated to stage IV
07.05.18 CAT scan, lung metastasis 11 mm
04.06.18 ileostomy reversal
26.06.18 wedge VATS surgery

User avatar
betsydoglover
Posts: 911
Joined: Mon Aug 14, 2006 2:31 pm
Facebook Username: Betsy Lindh Williams
Location: Maryland - outside DC

Re: PET scan not good :(. Anybody's surgeon was able to find a 8mm lung nodule via VATS?

Postby betsydoglover » Thu Jul 05, 2018 2:53 pm

Sorry for your news. I had a 9x11 mm met removed from inside right lower lobe, via VATS, in 2009.

Someone said that the surgeon has to be able to feel the nodule with his/her hands in order to remove it with VATS. I want you to know that this is not necessarily true. In my case (deep in lower lobe and not visible) nuclear med material was inserted into the met area by an interventional radiologist, under CT guidance, so that during surgery, surgeon could "go for the hot spot" since the met itself was not visible (or able to be felt). It worked great - and my surgeon said he did it several times a year (and so did other surgeons in the area).

Just wanted you to know that there may be another option.

Take care,
Betsy
diag. Stage IV, 5/05, liver met
lap sigmoid colectomy, 6/05
6 cycles Xeloda/oxaliplatin/Avastin (NED after 2)
11/08 9x13mm right lower lobe lung nodule; removed via VATS 4/09
NED
6 cycles Xeloda + Avastin
Avastin only 10/09-5/11
Still NED 06/18

User avatar
Atoq
Posts: 264
Joined: Wed Oct 25, 2017 9:31 am

Re: PET scan not good :(. Anybody's surgeon was able to find a 8mm lung nodule via VATS?

Postby Atoq » Thu Jul 05, 2018 4:48 pm

betsydoglover wrote:Sorry for your news. I had a 9x11 mm met removed from inside right lower lobe, via VATS, in 2009.

Someone said that the surgeon has to be able to feel the nodule with his/her hands in order to remove it with VATS. I want you to know that this is not necessarily true. In my case (deep in lower lobe and not visible) nuclear med material was inserted into the met area by an interventional radiologist, under CT guidance, so that during surgery, surgeon could "go for the hot spot" since the met itself was not visible (or able to be felt). It worked great - and my surgeon said he did it several times a year (and so did other surgeons in the area).

Just wanted you to know that there may be another option.

Take care,


In my case the node was not deep and it was sufficient to use two fingers to detect it. Everything was done through a single port and lasted 30 min. The CT was instead used to do the biopsy. Today (after a week) I was already swimming and did not notice any difference in lung capacity.

Atoq
45 year old, mother of 2
Dx rectal cancer October 2017
At least T3N2aMX (suspect metastasis to one lung 8 mm)
Lynch negative
Neoadjuvant chemoradiotherapy Xeloda + 25x2 Gy
05.12.17 laparotomic surgery for blockage, colostomy
25.01.18 laparotomic lar, hysterectomy, ileostomy
05.03.18 core needle biopsy of lung, updated to stage IV
07.05.18 CAT scan, lung metastasis 11 mm
04.06.18 ileostomy reversal
26.06.18 wedge VATS surgery

User avatar
juliej
Posts: 2841
Joined: Thu Aug 05, 2010 12:59 pm

Re: PET scan not good :(. Anybody's surgeon was able to find a 8mm lung nodule via VATS?

Postby juliej » Thu Jul 05, 2018 5:43 pm

Sent you a PM.

Juliej
Stage IV, liver/lung mets 8/4/2010
Xelox+Avastin 8/18/10 to 10/21/11
LAR, liver resec, HAI pump 11/11
Double lung surgery + ileo reversal 2/12
Adjuvant Xeloda 3-9/12
VATS rt. lung 12/21/12 - benign granuloma!
NED 3/17/12 to 5/11/2018, CEA<1

Beccaschocked
Posts: 29
Joined: Mon Oct 30, 2017 7:33 pm
Facebook Username: Becca Fender schock

Re: PET scan not good :(. Anybody's surgeon was able to find a 8mm lung nodule via VATS?

Postby Beccaschocked » Wed Jul 11, 2018 6:09 pm

We watched mine for nearly two years before it began to grow as it was unaffected by chemo and stable size. During that time there was no visible spread or progression.

Unfortunately mine was in a more precarious spot and when it did begin to grow I had to have lobectomy to remove the little bugger. That said, recovery was quick and easy. No chemo and I was running and hiking within a few weeks.

Six months out now, praying all will come back good on my upcoming scan.
Dx @ 32, mom to 6 week old and 2 year old (now 3 & 5)
March 2015 stage IV colon cancer Mets to liver. CEA > 8,000.
April 2015- June 15; 3 infusions folfoxiri +avastin, 4 infusions folfox
July 2015 colon & liver resection followed by 6 infusions of folfiri
January 2016-May 2017 NED (5mm lung nodule stable)
October 2017- growing lung nodule 12mm from 5mm-Confirmed recurrence - CEA 2.5
November 2017- lobectomy- no chemo
January 2018- CT & PET back to NED. CEA 1.3; 1.4


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