CT Scan Results- please help----UPDATE

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very worried husband
Posts: 130
Joined: Mon Mar 28, 2011 1:20 am

CT Scan Results- please help----UPDATE

Postby very worried husband » Tue Aug 27, 2013 5:58 pm

Dear All,

As my name and signature shows , i am caregiver to my beloved wife who was diagnosed with colon cancer 31 months ago in January 2011 at young age of 25. she was/is doing remarkably well. Last week she had her yearly colonoscopy and endoscopy that were perfect. She had her CEA at 1.20 and CA 125 At 11.
She had her yearly CT scan on Aug 13 and we just got back from the dr. The results read '' There is a new left costophrenic angle nodule at the lung base measuring 6mm , non specific and likely inflammatory /post inflammatory nature''.
Interpretation: No evidense of recurrent disease. note is made of a new left costophrenic angle pulmonary nodule indeterminate significance likely post inflammatory however a dedicated CT thorax recommended...

since our main dr was in meeting, the new dr said she will get back to us after consulting with the main dr.
What does it mean? what is the normal procedure if it is cancer? i am in ontario...
we are devastated..... what questions/ actions we need to take?????
please help...

************************ UPDATE*****************

So we saw our oncologist today. Still not 100 % confirmed that it is cancer or what. there is another nodule 7mm also there in the lower left lobe. so there are two, one 6mm and another 7mm.the 6mm seen last time is unchanged... The onco decided to re scan in 2 months time....... He said they are not overly worried as her cancer markers are all normal and even decreased from last time in may. He said if the cancer markers had shown upward trend, he would be certain that it is cancer...... since they did not have a thorax CT to compare, he says we will recheck, if they gets bigger, they will start her on chemo/ or whatever is needed..... ...... our life still hangs on for the next two months.....i hate cancer.....
Last edited by very worried husband on Wed Sep 04, 2013 9:14 pm, edited 1 time in total.
Caregiver to Wife age25
Diagnosed Colon IIIB Jan2011
7/29 Nodes +
5FU+Oxi in china. Feb-Aug 2011
CEA@Diagnose:0.79
Immunological chemistry: Ki-67 (+), MSH2(+), MLH1(++), ERCC1 (-)
NED Supplements: Aspirin,Vit D,Calcium, Genoderma Lucidium
Baby born June 2015 :D :D :)

kiwiinoz
Posts: 1156
Joined: Thu Jan 03, 2013 11:44 pm

Re: CT Scan Results- please help

Postby kiwiinoz » Tue Aug 27, 2013 6:48 pm

Hi
First of all we are not doctors so everything we say is our own opinion based on experience.
I am not sure how reliable her CEA levels are? Mine has never been a market and was 1.60 at dx and the highest it has ever been is 2.00 which is well within the standard range for a normal individual. CEA at 1.20 assuming CEA is a reliable marker is a very good indication that there is no active cancer.
The CT report simply states that there is some inflamation, or some post inflamation which is showing up. People on this board have had all sorts of lung junk pop up and worried themselves, and it simply turns out to be nothing other than inflamation from an infection.
I'd be happy with that scan result and go with a follow up dedicated CT Thorax scan.
Not sure if it going to tell you a lot at that size (6mm) and PET scan would be pretty unreliable at that size also as it doesn't show up any metabolic activity with any degree of reliability for spots under 1 cm (10 mm) so it is too small.
I'd sit back and scan again in a few months to see if it has changed in size but at this stage the report and your interim onc do not appear to be too worried so I'd suggest you may be in the unfortunate position of waiting for further scans to compare against this one to see if there is any change.
However if I had this scan I'd naturally be worried but it does seem to be of a positive nature at this stage.
I am sure others will pop in with their opionions soon
Kiwi
Stage IV Rectal Cancer (39 Year old male at dx)
pT3N0M1 (wish that was M0)
Diagnosed 05 Dec 2012
LAR 05 Jan 2013
VATS 27 Feb 2013
FOLOFX April 2013 - Sep 2013
Clear Scan 03 Dec 2013 - 22 May 2019
Port Out 26 March 2015

disco nap
Posts: 991
Joined: Sat Aug 07, 2010 10:45 am

Re: CT Scan Results- please help

Postby disco nap » Tue Aug 27, 2013 7:05 pm

The report said NED and just to watch the thing to be on the safe side. The people normally can tell what they're looking at and they've determined a high probability of it being just a bump from inflammation. Not cancer.

Don't be devastated, be happy! (And do a follow up like they recommend.)
DX July 2 '10 CC Stage IIIC, 11/18 nodes+
Right Hemi July 6 '10
Folfox: Aug 17'10 - Feb 17'11
Mar 2012: Lynch Syndrome MLH1
"Declared well" and been well ever since.
Update: Oct 2019 - still NED.

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O Stoma Mia
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Re: CT Scan Results- please help

Postby O Stoma Mia » Tue Aug 27, 2013 8:15 pm

very worried husband wrote:... '' There is a new left costophrenic angle nodule at the lung base measuring 6mm, non specific and likely inflammatory /post inflammatory nature''. Interpretation: "No evidence of recurrent disease. note is made of a new left costophrenic angle pulmonary nodule indeterminate significance likely post inflammatory however a dedicated CT thorax recommended"

... what is the normal procedure if it is cancer? I am in Ontario...


very worried husband - I am not an expert in this area, but I think that it is probably standard procedure to have a second scan done to try to confirm the results of the first. If the determination is that the suspicious nodule is cancerous, then they might try targeted radiotherapy to that particular point -- assuming such a procedure is feasible -- along with an additional course of chemotherapy.

Forum members having actual experience in this area might have something more specific to say.

Stereotactic Radiation Surgery (SRS) -- available in several places in Ontario:
http://www.jcc.hhsc.ca/blank.cfm?id=300

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very worried husband
Posts: 130
Joined: Mon Mar 28, 2011 1:20 am

Re: CT Scan Results- please help

Postby very worried husband » Tue Aug 27, 2013 9:08 pm

Thanks for your replies and encouraging words. well, CEA is not a good marker for her. it was 0.79 at diagnoses. and it is between the range of 0.50 and 2 during her treatment. she was diagnosed within a month of our weddings, and we were waiting so eagerly for our kids... we both love kids to unbelievable levels... and we were told no kids for 3 years. she was suppose to reach three year mark in January and this was the last hurdle, which unfortunately brought this news...
what is disturbing to us is that she had only very bad fever and cough last year in July just before her CT scan and that was clear. so not sure what else could cause inflammation?
Any feedback with the experience of Stereotactic Radiation Surgery (SRS) in GTA area, please help... is it the only option?
could we take it as a positve sign that if it is cancer, its very small and it took so long to grow, will it make any difference to her prognosis...sorry if my posts/questions does not make sense, my head is all over the place, words cannot describe how much i love her....
Caregiver to Wife age25
Diagnosed Colon IIIB Jan2011
7/29 Nodes +
5FU+Oxi in china. Feb-Aug 2011
CEA@Diagnose:0.79
Immunological chemistry: Ki-67 (+), MSH2(+), MLH1(++), ERCC1 (-)
NED Supplements: Aspirin,Vit D,Calcium, Genoderma Lucidium
Baby born June 2015 :D :D :)

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raym
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Joined: Sat Apr 16, 2011 11:08 am
Location: South Central PA

Re: CT Scan Results- please help

Postby raym » Tue Aug 27, 2013 9:29 pm

I have had several lung thingies over the years and have seen other posters here with the same. There's really not much to do until there is more suspicion of metastatic disease. There's a few things on my lungs they've been remarking on for over a year..just something they keep an eye on.
3/11 IIIC +/FOLFOX
4/12 HIPEC
6/12 Chmo/Rad
9/12 XELIRI+Avast/Zltra
9/13 Plvic Absc,stpd chemo
11/13 Tumr rmvd frm Lap Port incis
12/13 Xeloda
1/14 Cardiac Issue no Xeloda/5FU
3/14 Irinotecan
6/14 Stopped chemo
8/14 Clin Trial
9/14 Infectn - Stpd Trial

Cb75
Posts: 1216
Joined: Sun Apr 22, 2012 3:52 pm
Location: Ontario, Canada

Re: CT Scan Results- please help

Postby Cb75 » Tue Aug 27, 2013 9:47 pm

Srs is not the only option. It can also be surgically removed depending on where it is located. I am being treated at princess Margaret and believe they offer these options.
39y female Stage IV
diagnosed April 2012
sigmoid resect May 2012
liver resect Aug 2012
Folfox Oct 2012
lungs Sep 2013
R and L laser lung resection Nov 2013/Feb 2014
FOLFIRI and Avastin Apr 2014 ongoing...

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O Stoma Mia
Posts: 1603
Joined: Sat Jun 22, 2013 6:29 am

Re: CT Scan Results- please help

Postby O Stoma Mia » Tue Aug 27, 2013 9:52 pm

very worried husband wrote:Any feedback with the experience of Stereotactic Radiation Surgery (SRS) in GTA area, please help... is it the only option? ...



Hi very worried husband - I don't have any experience in this area, but I noticed that there is one forum member who is going to have SRS a couple of weeks from now:

Pet scan results
http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=43429&p=308431#p308431

michelle c
Posts: 1914
Joined: Wed Dec 02, 2009 3:58 am

Re: CT Scan Results- please help

Postby michelle c » Tue Aug 27, 2013 9:58 pm

Interpretation: No evidense of recurrent disease.

I know how easy it is to think the worst but just try to focus on the report "No evidence of recurrent disease". They always report everything they see because they are obliged to do so.

At times I've convinced myself my cancer is back because I thought the worst and ending up making myself sick with worry.

Hope you get to speak with your onc soon,

Wishing you and your wife the best,

Michelle xox
25 May 09 Dx with CC (sigmoid colon) 2 days after my 44th b'day
CEA prior to surgery 4.7
3 Jun 09 LAR - Stage III 3/10 lymph nodes
6 Jul - 10 Dec 09 12 cycles FOLFIRI
Genetic testing - inconclusive for Lynch
Jul 12 port removed & hernia repair

smokeyjoe
Posts: 137
Joined: Wed Sep 21, 2011 8:40 am

Re: CT Scan Results- please help

Postby smokeyjoe » Wed Aug 28, 2013 8:36 am

Where is your wife being treated? I'd check out Princess Margaret too, look on their clinical trials, they have a trial for treating mets with something (can't recall right now what it is .... I am thinking cyberknife). I would think they will do more tests and scans before they come to the conclusion whether or not it is in fact cancer.

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very worried husband
Posts: 130
Joined: Mon Mar 28, 2011 1:20 am

Re: CT Scan Results- please help

Postby very worried husband » Wed Aug 28, 2013 9:04 am

Thanks everyone for your input.
smokeyjoe, she is being treated in Cambridge Ontario. All her treatment was done in China, as she was diagnosed there. she finished her 5Fu in china in August, 2011. we are just doing follow ups in cambridge since March, 2012.
she had her CT scan last year in July and that was good. she just had her colonoscopy/endoscopy last week and that was also good along with all the blood work.
I just got a call from our oncologist office. They want to do CT scan again tomorrow and we will see the oncologist on 4th September. I will also go and speak to them tomorrow about referral to princess Margaret. We pray that it is not cancer...
Caregiver to Wife age25
Diagnosed Colon IIIB Jan2011
7/29 Nodes +
5FU+Oxi in china. Feb-Aug 2011
CEA@Diagnose:0.79
Immunological chemistry: Ki-67 (+), MSH2(+), MLH1(++), ERCC1 (-)
NED Supplements: Aspirin,Vit D,Calcium, Genoderma Lucidium
Baby born June 2015 :D :D :)

disco nap
Posts: 991
Joined: Sat Aug 07, 2010 10:45 am

Re: CT Scan Results- please help

Postby disco nap » Thu Aug 29, 2013 2:31 pm

Keep us updated VWH. I am thinking of you and your wife.
DX July 2 '10 CC Stage IIIC, 11/18 nodes+
Right Hemi July 6 '10
Folfox: Aug 17'10 - Feb 17'11
Mar 2012: Lynch Syndrome MLH1
"Declared well" and been well ever since.
Update: Oct 2019 - still NED.

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O Stoma Mia
Posts: 1603
Joined: Sat Jun 22, 2013 6:29 am

Re: CT Scan Results- please help

Postby O Stoma Mia » Thu Aug 29, 2013 7:13 pm

very worried husband wrote:... They want to do CT scan again tomorrow and we will see the oncologist on 4th September. ...


Hi VWH - After re-reading the earlier comments posted on this thread, my general feeling is that you should not worry at all, because the report did say that it was likely just a post-infection inflammation. One thing you could do before your September 4th meeting with the oncologist, however, is to put together a list of questions that would help you clarify the situation. For example, some of the things you might want to ask are:

1. Where, exactly is this nodule located? Is it inside the lung, or is it in the space between the lung and the diaphragm?
2. What do they mean by "nodule"-- are they referring to a lymph node or are they referring to some other kind of structure?
3. The new CT scan that they are requesting -- is this the CT Thorax mentioned earlier? If so, is it being run at the same definition as the earlier one, or is the machine now set for "High Definition" this time around?
4. Is the radiologist able to discern the shape of the nodule? If the nodule is in fact a lymph node and it still retains the shape of a bean, then the 6mm spot is likely due to inflammation, but if the 6mm spot is a cancerous lymph node, then it will likely be amorphous in shape.
5. Is the new CT scan being run too soon after the original one? Normally they wait several months to do the follow-up CT in order to let any possible inflammation subside.
6. Is it possible to get a second copy of the CT scan report? If so, this copy could be sent out for a second opinion to one of the hospitals that do second-opinion reviews.

I'm not a specialist in this area, but all in all I would not get too worried just now. The normal CEA values are a good sign. They suggest that there are no metastases contributing to the tumor marker value. (If the CEA values were out-of-range, then this would be a different matter, but since they are within the normal range there is less cause for concern.)

Please let us know what you find out.

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very worried husband
Posts: 130
Joined: Mon Mar 28, 2011 1:20 am

Re: CT Scan Results- please help

Postby very worried husband » Thu Aug 29, 2013 9:07 pm

Thank you so much disco nap and O stoma mia for thinking about us.
Well, we had the CT scan today and we would see the Onco on the 4th September. This looked a different CT as she did not need to drink the cocktail before the test.( CT with contrast, i think). Normally and luckily my wife handles things better than me as I am an emotional wreck. unfortunately, her father is also dealing with stage 4 lung cancer back home, so she would like to see her father before any kind of treatment starts( hopefully that won't be needed).
I was also thinking that they would take some time before re doing the CT scan, but they were so quick. The Dr mentioned that given her age (28), they would be as aggressive as they could. so may be that could be the reason that they did the scan so quick.
I am researching traditional Chinese medicine and the T Cell therapy things in Europe. She did use TCM with the conventional chemotherapy the last time. her CEA of 1.20 is still a great news, and we hope and pray that there is nothing serious.
Hopefully i will update this on the 4th with a good news....
Caregiver to Wife age25
Diagnosed Colon IIIB Jan2011
7/29 Nodes +
5FU+Oxi in china. Feb-Aug 2011
CEA@Diagnose:0.79
Immunological chemistry: Ki-67 (+), MSH2(+), MLH1(++), ERCC1 (-)
NED Supplements: Aspirin,Vit D,Calcium, Genoderma Lucidium
Baby born June 2015 :D :D :)

User avatar
very worried husband
Posts: 130
Joined: Mon Mar 28, 2011 1:20 am

Re: CT Scan Results- please help----UPDATE

Postby very worried husband » Wed Sep 04, 2013 10:20 pm

*********************** UPDATE*****************

So we saw our oncologist today. Still not 100 % confirmed that it is cancer or what. there is another nodule 7mm also there in the lower left lobe. so there are two, one 6mm and another 7mm.the 6mm seen last time is unchanged... The onco decided to re scan in 2 months time....... He said they are not overly worried as her cancer markers are all normal and even decreased from last time in may. He said if the cancer markers had shown upward trend, he would be certain that it is cancer...... since they did not have a thorax CT to compare, he says we will recheck, if they gets bigger, they will start her on chemo/ or whatever is needed..... ...... our life still hangs on for the next two months.....i hate cancer.....
Caregiver to Wife age25
Diagnosed Colon IIIB Jan2011
7/29 Nodes +
5FU+Oxi in china. Feb-Aug 2011
CEA@Diagnose:0.79
Immunological chemistry: Ki-67 (+), MSH2(+), MLH1(++), ERCC1 (-)
NED Supplements: Aspirin,Vit D,Calcium, Genoderma Lucidium
Baby born June 2015 :D :D :)


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