Lymph nodes and chemo

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Nohogirl
Posts: 99
Joined: Sun Oct 14, 2018 12:15 am

Lymph nodes and chemo

Postby Nohogirl » Wed Dec 26, 2018 6:52 pm

Hi All,

Haven't been active lately, were busy with hubby's chemo, side effects,.my own surgery.

So before my husband started his post op chemo he had one enlarged (9mm) common iliac lymph node showing on both CT and MRI. None of the doctors were concerned stating that this is most likely an inflammation rather than cancer. Our new oncologist said lets start the chemo and we will see. The plan is 8 cycles of Folfox.
When hubby completed his 4 cycles, he had his midchemo MRI and the lymph node is showing unchanged, still 9 mm. "Stable density 9mm lymph node.......grossly unchanged"

Our oncologist was on vacation so it was the nurse practitioner who discussed the results with us. All she said was that the lymph node is unchanged and that my husband MRI looks good. Both hubby and I are still confused. Don't know if this is good or bad.

Anyone had similar situation? Does unchanged lymph node mean it is cancer and is not responding to chemo or it means it is unlikely cancer and that is why its stable ( I'd assume chemo doesn't shrink inflammation)

The nurse didn't sound too knowledgeable about this type of situation. While we are waiting for our oncologist to come back from vacation, in the meantime any insight will be appreciated.
04/18 DH 49 diag.stage 2A T3N0M0 rectal cancer moderately differentiated.
05/18 chemorad. (Xeloda) 28 days
08/18 Surgery- 24 cm, including entire rectum out
Path -Stage II T2N0M0 moderate to poorly diff. adenocarcinoma
0 of 15 lymph nodes
No PNI
No LVI
Clear margins
Chemo Regression Grade 3
10/18 Started Folfox

Punky44
Posts: 168
Joined: Mon Oct 01, 2018 4:29 pm

Re: Lymph nodes and chemo

Postby Punky44 » Thu Dec 27, 2018 8:57 am

Wish I had an answer for you—curious to see what others say because I remember talking about this node with you awhile back. How did the rest of the scan results go? Is the cancer shrinking?
Caregiver to my amazing mom (68)
10/1/18 DX with rectal cancer; CEA 17
MRI/CT/PET puts staging at T3N2M0
Trying total neoadjuvant therapy—chemo first, then short course radiation, then surgery
11/5/18 started Folfox—6 down, 2 to go!

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.

Punky44
Posts: 168
Joined: Mon Oct 01, 2018 4:29 pm

Re: Lymph nodes and chemo

Postby Punky44 » Thu Dec 27, 2018 8:59 am

Oh duh, disregard my question—your hubby already had his radiation and surgery! (For a brief second I thought he was doing neoadjuvant chemo). So there is nothing to shrink! :)
Caregiver to my amazing mom (68)
10/1/18 DX with rectal cancer; CEA 17
MRI/CT/PET puts staging at T3N2M0
Trying total neoadjuvant therapy—chemo first, then short course radiation, then surgery
11/5/18 started Folfox—6 down, 2 to go!

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.

Nohogirl
Posts: 99
Joined: Sun Oct 14, 2018 12:15 am

Re: Lymph nodes and chemo

Postby Nohogirl » Thu Jan 03, 2019 10:18 pm

Punky44 wrote:Oh duh, disregard my question—your hubby already had his radiation and surgery! (For a brief second I thought he was doing neoadjuvant chemo). So there is nothing to shrink! :)

Hi Punky!

Yes my husband had chemoradiation before his surgery
His chemo was in the form of pill called Xeloda.
His tumor had shrunk from approximately 5.8 cm to 2.2. So only half. This mysterious lymph node was not there at the time of diagnosis nor was it before his surgery. It only showed up after his surgery. So we are quite puzzled about it.
04/18 DH 49 diag.stage 2A T3N0M0 rectal cancer moderately differentiated.
05/18 chemorad. (Xeloda) 28 days
08/18 Surgery- 24 cm, including entire rectum out
Path -Stage II T2N0M0 moderate to poorly diff. adenocarcinoma
0 of 15 lymph nodes
No PNI
No LVI
Clear margins
Chemo Regression Grade 3
10/18 Started Folfox

Stewsbetty
Posts: 140
Joined: Thu Jul 14, 2016 7:08 am

Re: Lymph nodes and chemo

Postby Stewsbetty » Fri Jan 04, 2019 10:10 am

I had one enlarged node after surgery (don’t know its name but in the retroperitoneal area). They thought maybe inflammation but after staying enlarged throughout chemo we did a PET and it was confirmed cancerous.
I would inquire about a PET to verify though I guess that wouldn’t be done til after chemo. I am guessing they will just want you to hold the line until chemo is complete and then check in things. Not sure if a liquid biopsy would help in this case? I was quite frustrated after completing 6 months of chemo to find that it had not helped with that node.
Hope your oncologist gives you more info on their return.

Beth
42yo At diagnosis. Female in BC, Canada
Dx: CC ascending
Right Hemi colectomy 06/16 clear margins
Adenocarcinoma 6cm High Grade
pT3 pN2a Stage 3
10 out of 16 lymph involved
MSI-h, Kras mut, Braf wild
Finished chemo Feb. 2017
PET scan showing active area April 2017
July 2017 CT showing LN mass and spread to other LN
Stage 4
Aug 2017 failed Fofiri
Sept 2017 keytruda
Nov 2017 CT scans show significant shrinkage in tumours
Feb 2018 CT continued shrinkage
May 2018 CT shrinkage and stable spots

Nohogirl
Posts: 99
Joined: Sun Oct 14, 2018 12:15 am

Re: Lymph nodes and chemo

Postby Nohogirl » Fri Jan 04, 2019 12:44 pm

Stewsbetty wrote:I had one enlarged node after surgery (don’t know its name but in the retroperitoneal area). They thought maybe inflammation but after staying enlarged throughout chemo we did a PET and it was confirmed cancerous.
I would inquire about a PET to verify though I guess that wouldn’t be done til after chemo. I am guessing they will just want you to hold the line until chemo is complete and then check in things. Not sure if a liquid biopsy would help in this case? I was quite frustrated after completing 6 months of chemo to find that it had not helped with that node.
Hope your oncologist gives you more info on their return.

Beth

Beth how big was your node and was it staying the same size during chemo or it was getting bigger. My husband is going to have pet scan in couple of weeks. Hopefully that will clarify things a bit. I am holding my breath
04/18 DH 49 diag.stage 2A T3N0M0 rectal cancer moderately differentiated.
05/18 chemorad. (Xeloda) 28 days
08/18 Surgery- 24 cm, including entire rectum out
Path -Stage II T2N0M0 moderate to poorly diff. adenocarcinoma
0 of 15 lymph nodes
No PNI
No LVI
Clear margins
Chemo Regression Grade 3
10/18 Started Folfox

e_enyedy
Posts: 21
Joined: Sat Nov 25, 2017 5:28 pm

Re: Lymph nodes and chemo

Postby e_enyedy » Fri Jan 04, 2019 9:17 pm

Ask your Onco to order a PET/CAT scan.

E
77 yrs male (73 at Dx)
2/13 Dx Carcinoma, Sigmoid Colon
3/13 Sigmoid Colon Hemicolectomy,( 12"+)
3/13 Pathology Staging: T1N0M0; no follow-up chemo
5/15 Recurrence: in pre-sacral space -no other mets detected (Instantly became Stage IV)
5/15 Started 8 sessions of Folfox + Avastin
11/15 Finished chemo, PET/CT: NED
11/15 Started Xeloda+ Avastin every 3 weeks. Still Doing it.
Still NED -(Hope treatment keeps working)

Stewsbetty
Posts: 140
Joined: Thu Jul 14, 2016 7:08 am

Re: Lymph nodes and chemo

Postby Stewsbetty » Fri Jan 11, 2019 6:51 am

Nohogirl wrote:
Stewsbetty wrote:I had one enlarged node after surgery (don’t know its name but in the retroperitoneal area). They thought maybe inflammation but after staying enlarged throughout chemo we did a PET and it was confirmed cancerous.
I would inquire about a PET to verify though I guess that wouldn’t be done til after chemo. I am guessing they will just want you to hold the line until chemo is complete and then check in things. Not sure if a liquid biopsy would help in this case? I was quite frustrated after completing 6 months of chemo to find that it had not helped with that node.
Hope your oncologist gives you more info on their return.

Beth

Beth how big was your node and was it staying the same size during chemo or it was getting bigger. My husband is going to have pet scan in couple of weeks. Hopefully that will clarify things a bit. I am holding my breath


Sorry I haven’t been on for a bit. I think it was just over 1 cm. I think for abominable LN the threshold is about 1cm. It is a an anxious time as we wait for tests and their results!
42yo At diagnosis. Female in BC, Canada
Dx: CC ascending
Right Hemi colectomy 06/16 clear margins
Adenocarcinoma 6cm High Grade
pT3 pN2a Stage 3
10 out of 16 lymph involved
MSI-h, Kras mut, Braf wild
Finished chemo Feb. 2017
PET scan showing active area April 2017
July 2017 CT showing LN mass and spread to other LN
Stage 4
Aug 2017 failed Fofiri
Sept 2017 keytruda
Nov 2017 CT scans show significant shrinkage in tumours
Feb 2018 CT continued shrinkage
May 2018 CT shrinkage and stable spots


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