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Recurrence lung nodules/lymph nodes: (PET) CT vs. markers

Posted: Mon May 20, 2019 12:50 am
by cvl
Hi everyone,

I am asking for my dad, he had surgery for CRC 3 years ago (Stage 2C).
On the latest CT appeared 2 lung nodules and 2 increased lymph nodes.
After CT - he did CEA, CA 19-9, etc. and all markers are in the limit. (CEA was indicator at discovery).

It follows to have a PET CT to clarify.

I was wondering if someone else knows about correlation with blood markers.
Question especially for people with lung nodules, if they want to share.

Thank you,

CV

Re: Recurrence lung nodules/lymph nodes: (PET) CT vs. markers

Posted: Wed May 22, 2019 4:08 pm
by juliej
cvel wrote:I am asking for my dad, he had surgery for CRC 3 years ago (Stage 2C).
On the latest CT appeared 2 lung nodules and 2 increased lymph nodes.
After CT - he did CEA, CA 19-9, etc. and all markers are in the limit. (CEA was indicator at discovery).

It follows to have a PET CT to clarify.

I was wondering if someone else knows about correlation with blood markers.
Question especially for people with lung nodules, if they want to share.

I had a definite rise in CEA with my lung nodules. So if CEA is a good indicator for your dad, those two nodules aren't necessarily mets. As you noted though, a PET CT should help clarify things. Better to look too close than miss something.

One time I had a CT report identify a suspicious and growing nodule as a met. My CEA did NOT rise with that one. It was removed via VATS and pathology showed it to be a benign granuloma, not cancer. Keep in mind the lungs do get benign growths from a variety of things -- for example, from tiny particles inhaled while you're gardening, from pollution or pollen, even tiny bugs inhaled when you're bicycling. :D

Hope this helps!
Juliej

Re: Recurrence lung nodules/lymph nodes: (PET) CT vs. markers

Posted: Wed May 22, 2019 4:40 pm
by rp1954
There's almost no detail to comment on or to compare there. Standard US oncology practices aren't highly geared for accumulation, biochemical assessment of risk, or detection of recurrence much beyond to monitor single/several CEA values.

Other places, they might combine several kind of data and series across previous time points, even below the upper limit values for standard labs, for some result or recommendations. We typically found that we needed more and better data and details for better answers.

Re: Recurrence lung nodules/lymph nodes: (PET) CT vs. markers

Posted: Thu May 23, 2019 1:55 am
by cvl
Hi,

Thanks you for your inputs.

Will definitely do the PET CT soon to see.
Sharing and supporting is great. Good luck everyone!

Regards,
CV