The Colon Club

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 . 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

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...

Any sharing is appreciated!

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

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.

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

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

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

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

Good luck,

Lee

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

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,

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

Sent you a PM.

Juliej

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.

Thanks for everybody's messages. I have just completed VATS and Path result said it's colon met . Clear margin, low grade.

Looks like chemo is due end of the month. I'm not too discouraged yet as the side effect hasn't kicked in...

Hope to be over soon!!!!

Great to hear you are safely through surgery .
My mum had not experienced any further issues and she actually did not do chemo .
Hope everything goes well for you with chemo .
Take care,
Stu

stu wrote:Great to hear you are safely through surgery .
My mum had not experienced any further issues and she actually did not do chemo .
Hope everything goes well for you with chemo .
Take care,
Stu

Thank you Stu! Your mom's case is one of my top ten fav.

My Oncologist said there are actually two different School of thoughts for my situation ... One is to do chemo and the other no. He opt for doing chemo given my age and physical fitness... And perhaps it only took 7 months for the met to show his activity level.

Well, as long as there's something to try and do, I will tough up and try again