Unusual To Go From Zero To Nine Lung Nodules In 6 Months?

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prayingforccr
Posts: 139
Joined: Sun Jun 28, 2020 4:44 pm

Unusual To Go From Zero To Nine Lung Nodules In 6 Months?

Postby prayingforccr » Mon Jun 07, 2021 4:12 pm

So..........I had a ct scan in november which was clear.

I had a ct scan three weeks ago which indicated NINE small (3-6mm) lung nodules which are currently too small to treat or biopsy.

So, I got to thinking. What was different from November until May?

Hyperbaric oxygen therapy. I did hbot 2 hours a day, five days a week.

I am hoping that the nodules (suspected of being metastasis) might actually be the effects of the hbot and NOT metastasis.

My oncologist at mskcc and I agreed to wait until August to do a rescan.

I have been doing the joe tippens protocol faithfully, and am hoping for much improved scans in august.

Is it rare to go from zero to nine lesions in so short a time?

Is it possible whatever is being picked up on the ct scan and identified as “lung nodules” are benign effects from hbot?

There is no lymph node involvement. No ascites. No pleural effusion.

CEA is 2.6.

I am currently asymptomatic.
Nov 2019: colonoscopy
Dec 2019: diagnosed with stage 3 rectal cancer 6+cm tumor
Jan-mar 2020: 20 sessions of radiation, mon-fri capecetibine, mon-fri clinical trial drug m3814
Apr 2020: tumor/scar 3.7cm
July 2020: began 8 treatmentsFOLFOX
August 2020: ct scan reveals scarbed reduced to 2.7cm CEA is 1.5
Nov 2020: Primary tumor had complete response. Possible tumor deposits on latest mri. Biopsy negative for cancer.
May 2021: Multiple lung nodules (3-6mm) on ct scan

Bpaint
Posts: 17
Joined: Sun Oct 11, 2020 8:54 pm

Re: Unusual To Go From Zero To Nine Lung Nodules In 6 Months?

Postby Bpaint » Tue Jun 08, 2021 9:18 am

I hope for you that your nodules aren’t metastasis. What does your oncologist think about the nodules being caused by the oxygen therapy?

I think lung nodules can pop up quickly though, unfortunately. My husband had a couple of lung nodules that disappeared after folfox, but then when he went off chemo for 2 months for surgery, his post surgery scan showed 10 new lung nodules. They are all small (all less than 5mm), but they popped up in less than 3 months. But, his cancer was more widespread than yours to begin with, with spread in para-aortic lymph nodes.
My husband (age 41 at dx):
8/20 CRC Stage 4. Mets to lungs, liver, distant lymph nodes (25+)
MSS, KRAS wild
CEA 713 at dx
Folfox (12 rounds)
CEA 113
Liver, colon and lymph node resection scheduled for 4/9/21

prayingforccr
Posts: 139
Joined: Sun Jun 28, 2020 4:44 pm

Re: Unusual To Go From Zero To Nine Lung Nodules In 6 Months?

Postby prayingforccr » Tue Jun 08, 2021 9:51 am

My oncologist and the radiologist didn’t know that I had done the hbot.

I guess I was just hoping that the fact that I went from 0 to 9 in such a short period of time would be unusual :(

And that maybe what was picked up on the ct scan are some sort of treatment effect from the hbot.
Nov 2019: colonoscopy
Dec 2019: diagnosed with stage 3 rectal cancer 6+cm tumor
Jan-mar 2020: 20 sessions of radiation, mon-fri capecetibine, mon-fri clinical trial drug m3814
Apr 2020: tumor/scar 3.7cm
July 2020: began 8 treatmentsFOLFOX
August 2020: ct scan reveals scarbed reduced to 2.7cm CEA is 1.5
Nov 2020: Primary tumor had complete response. Possible tumor deposits on latest mri. Biopsy negative for cancer.
May 2021: Multiple lung nodules (3-6mm) on ct scan

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beach sunrise
Posts: 500
Joined: Thu Mar 05, 2020 7:14 pm

Re: Unusual To Go From Zero To Nine Lung Nodules In 6 Months?

Postby beach sunrise » Tue Jun 08, 2021 10:01 am

Hopefully its just the HBOT (if it is that) kicking in lymphatic drainage.
Keep us posted!
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
High dose IVC 1 1/2 wks before surgery. Continue still twice a week
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug
MHL1+
PMS2+
MSH2+
MSH6+
POLD1 , KRAS Q61H
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"

prayingforccr
Posts: 139
Joined: Sun Jun 28, 2020 4:44 pm

Re: Unusual To Go From Zero To Nine Lung Nodules In 6 Months?

Postby prayingforccr » Tue Jun 08, 2021 10:19 am

beach sunrise wrote:Hopefully its just the HBOT (if it is that) kicking in lymphatic drainage.
Keep us posted!


Do you think it unusual to go from 0 to 9 lung nodules in 6 months with no other signs of disease?
Nov 2019: colonoscopy
Dec 2019: diagnosed with stage 3 rectal cancer 6+cm tumor
Jan-mar 2020: 20 sessions of radiation, mon-fri capecetibine, mon-fri clinical trial drug m3814
Apr 2020: tumor/scar 3.7cm
July 2020: began 8 treatmentsFOLFOX
August 2020: ct scan reveals scarbed reduced to 2.7cm CEA is 1.5
Nov 2020: Primary tumor had complete response. Possible tumor deposits on latest mri. Biopsy negative for cancer.
May 2021: Multiple lung nodules (3-6mm) on ct scan

Claudine
Posts: 538
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: Unusual To Go From Zero To Nine Lung Nodules In 6 Months?

Postby Claudine » Tue Jun 08, 2021 10:20 am

My husband went from none to many small lung nodules in that period of time; but he also developed a large adrenal met.
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A
No primary (involuted?)
Lytic tumor L4 vertebrae, EBRT 04/18, SBRT 02/19
Resect small intestine 05/18 (no cancer - Crohn's)
Failed adjuvant Xelox
Folfiri + Avastin 03/19 to 01/20
6.7 cm left adrenal mass 03/19, successful resection 02/20
CEA since 03/19: low 3.2, now 81.1
Scan 03/19: Multiple small lung nodules, now gone/calcified
PET 04/20 uptake by L4
L3-L4-L5 fusion surgery and partial corpectomy 05/20
Scan 06/17/2021: stable

prayingforccr
Posts: 139
Joined: Sun Jun 28, 2020 4:44 pm

Re: Unusual To Go From Zero To Nine Lung Nodules In 6 Months?

Postby prayingforccr » Tue Jun 08, 2021 10:25 am

Claudine wrote:My husband went from none to many small lung nodules in that period of time; but he also developed a large adrenal met.


Hi, Claudine.

But he was able to get rid of them with FOLFIRI/Avastin?

I figure the bullets left in my gun are 1) Tippens protocol 2) FOLFIRI/Avastin 3) YAG surgery in Germany
Nov 2019: colonoscopy
Dec 2019: diagnosed with stage 3 rectal cancer 6+cm tumor
Jan-mar 2020: 20 sessions of radiation, mon-fri capecetibine, mon-fri clinical trial drug m3814
Apr 2020: tumor/scar 3.7cm
July 2020: began 8 treatmentsFOLFOX
August 2020: ct scan reveals scarbed reduced to 2.7cm CEA is 1.5
Nov 2020: Primary tumor had complete response. Possible tumor deposits on latest mri. Biopsy negative for cancer.
May 2021: Multiple lung nodules (3-6mm) on ct scan

Claudine
Posts: 538
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: Unusual To Go From Zero To Nine Lung Nodules In 6 Months?

Postby Claudine » Tue Jun 08, 2021 10:36 am

Yes he was! That's a good plan you've got :)
IMO any met that can be surgically removed is "preferable", if that makes sense. Unfortunately for my husband, one can hardly remove a vertebrae...
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A
No primary (involuted?)
Lytic tumor L4 vertebrae, EBRT 04/18, SBRT 02/19
Resect small intestine 05/18 (no cancer - Crohn's)
Failed adjuvant Xelox
Folfiri + Avastin 03/19 to 01/20
6.7 cm left adrenal mass 03/19, successful resection 02/20
CEA since 03/19: low 3.2, now 81.1
Scan 03/19: Multiple small lung nodules, now gone/calcified
PET 04/20 uptake by L4
L3-L4-L5 fusion surgery and partial corpectomy 05/20
Scan 06/17/2021: stable

boxhill
Posts: 730
Joined: Fri Apr 06, 2018 11:40 am

Re: Unusual To Go From Zero To Nine Lung Nodules In 6 Months?

Postby boxhill » Tue Jun 08, 2021 6:35 pm

Hyperbaric oxygen therapy. I did hbot 2 hours a day, five days a week.


Why? If it was to treat some lung infection, that itself could have caused the lung nodules.
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 LN,5 mesentery nodes
5mm liver met
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/18 FOLFOX
7/18 and 11/18 CT NED
12/18 MRI 5mm liver mass, 2 LNs in porta hepatis
12/31/18 Keytruda
6/19 Multiphasic CT LNs normal, Liver stable
6/28/19 Pause Key, predisone for joint pain
7/31/19 Restart Key
9/19 CT stable
Pain: all fails but Celebrex
12/23/19 CT stable
5/19 MRI stable/NED
Stop Key
All MRIs NED

prayingforccr
Posts: 139
Joined: Sun Jun 28, 2020 4:44 pm

Re: Unusual To Go From Zero To Nine Lung Nodules In 6 Months?

Postby prayingforccr » Tue Jun 08, 2021 6:53 pm

boxhill wrote:
Hyperbaric oxygen therapy. I did hbot 2 hours a day, five days a week.


Why? If it was to treat some lung infection, that itself could have caused the lung nodules.


I did the hbot to try and heal radiation injuries (internal ulcers) and proctitis in my rectum.

The treatment wasn’t lung related, but I’m hoping what showed up on the ct scan are mucous plus/treatment effect.
Nov 2019: colonoscopy
Dec 2019: diagnosed with stage 3 rectal cancer 6+cm tumor
Jan-mar 2020: 20 sessions of radiation, mon-fri capecetibine, mon-fri clinical trial drug m3814
Apr 2020: tumor/scar 3.7cm
July 2020: began 8 treatmentsFOLFOX
August 2020: ct scan reveals scarbed reduced to 2.7cm CEA is 1.5
Nov 2020: Primary tumor had complete response. Possible tumor deposits on latest mri. Biopsy negative for cancer.
May 2021: Multiple lung nodules (3-6mm) on ct scan

boxhill
Posts: 730
Joined: Fri Apr 06, 2018 11:40 am

Re: Unusual To Go From Zero To Nine Lung Nodules In 6 Months?

Postby boxhill » Wed Jun 09, 2021 3:24 pm

I'm sorry you had such bad radiation injuries.

If you don't mind telling us, did the treatment seem to help? So many people have nasty effects from radiation, but this is the first time I've seen this therapy mentioned.
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 LN,5 mesentery nodes
5mm liver met
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/18 FOLFOX
7/18 and 11/18 CT NED
12/18 MRI 5mm liver mass, 2 LNs in porta hepatis
12/31/18 Keytruda
6/19 Multiphasic CT LNs normal, Liver stable
6/28/19 Pause Key, predisone for joint pain
7/31/19 Restart Key
9/19 CT stable
Pain: all fails but Celebrex
12/23/19 CT stable
5/19 MRI stable/NED
Stop Key
All MRIs NED

prayingforccr
Posts: 139
Joined: Sun Jun 28, 2020 4:44 pm

Re: Unusual To Go From Zero To Nine Lung Nodules In 6 Months?

Postby prayingforccr » Wed Jun 09, 2021 4:24 pm

boxhill wrote:I'm sorry you had such bad radiation injuries.

If you don't mind telling us, did the treatment seem to help? So many people have nasty effects from radiation, but this is the first time I've seen this therapy mentioned.


The hyperbaric oxygen therapy helped A LOT, as did acupuncture.
Nov 2019: colonoscopy
Dec 2019: diagnosed with stage 3 rectal cancer 6+cm tumor
Jan-mar 2020: 20 sessions of radiation, mon-fri capecetibine, mon-fri clinical trial drug m3814
Apr 2020: tumor/scar 3.7cm
July 2020: began 8 treatmentsFOLFOX
August 2020: ct scan reveals scarbed reduced to 2.7cm CEA is 1.5
Nov 2020: Primary tumor had complete response. Possible tumor deposits on latest mri. Biopsy negative for cancer.
May 2021: Multiple lung nodules (3-6mm) on ct scan

jts
Posts: 55
Joined: Sat Aug 24, 2019 3:07 pm

Re: Unusual To Go From Zero To Nine Lung Nodules In 6 Months?

Postby jts » Thu Jun 10, 2021 10:21 am

I read about this a little when they found my lung met. Lung met doubling time for CRC can be as little as about 30 days, which it was in my case. Here's a random paper where they find a median doubling time of about 66 days, but a pretty wide range: "Impact of Surgical Resection on Metachronous Metastases of Colorectal Cancer According to Tumor Doubling Time" Miyake et al.

What doubling time you may be seeing depends a lot on what the starting point is. What was the sensitivity of your old scan? If some nodules were 2mm then (easily overlooked), and 6mm now, that is an increase in volume of 27x, or about 4.7 doublings, which would be a DT of 38 days. If your old scan was completely clear, not even a 0.5mm hint of a nodule, then that was over 1728x increase in volume, or over 10.7 doublings - pretty extreme for 6 months.

If you want, you can look at your own scans. A 6mm nodule on your new scan should be pretty easy to see on a CT. Then go look at the same area on your old scan and see if there is /anything/. In my case the lung met was actually visible on previous scans, but the radiologists had reported it "clean" because the nodule was so small.

I hope yours turn out to be nothing!
Male 42 — stage IV RC
NRAS mutant - KRAS, BRAF wt
08/2019 DX 6 cm long tumor
09-10/2019 Chemo-radiation
12/2019 TME Surgery, clear margins, 7/16 nodes positive
Pathology: ypT3 ypN2b M0
01-06/2020 - FOLFOX
CEA only goes up during chemo: 2.4 --> 6.2
07/2020 6 mm tumor in lung, was growing fast during chemo
09/2020 VATS
01/2021 new 5mm cyst in liver, CEA continues to increase --> 8
06/2021 CEA takes a break - down to 6

prayingforccr
Posts: 139
Joined: Sun Jun 28, 2020 4:44 pm

Re: Unusual To Go From Zero To Nine Lung Nodules In 6 Months?

Postby prayingforccr » Thu Jun 10, 2021 11:12 am

“ New 0.2 cm nodule more caudally in the left lower lobe, probable mucous plugging.“

That’s the only allusion to lung nodes in the november scan.
Nov 2019: colonoscopy
Dec 2019: diagnosed with stage 3 rectal cancer 6+cm tumor
Jan-mar 2020: 20 sessions of radiation, mon-fri capecetibine, mon-fri clinical trial drug m3814
Apr 2020: tumor/scar 3.7cm
July 2020: began 8 treatmentsFOLFOX
August 2020: ct scan reveals scarbed reduced to 2.7cm CEA is 1.5
Nov 2020: Primary tumor had complete response. Possible tumor deposits on latest mri. Biopsy negative for cancer.
May 2021: Multiple lung nodules (3-6mm) on ct scan

User avatar
beach sunrise
Posts: 500
Joined: Thu Mar 05, 2020 7:14 pm

Re: Unusual To Go From Zero To Nine Lung Nodules In 6 Months?

Postby beach sunrise » Thu Jun 10, 2021 5:36 pm

What name, make and model of scan machine was used? Where did you have your scans?
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
High dose IVC 1 1/2 wks before surgery. Continue still twice a week
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug
MHL1+
PMS2+
MSH2+
MSH6+
POLD1 , KRAS Q61H
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"


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