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

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Bpaint
Posts: 68
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.
husband (age 41 at dx):
8/20 CRC Stage 4. Mets to lungs, liver, distant lymph nodes
MSS, KRAS wild
CEA 713 at dx
Folfox (12 rounds)
Liver, colon and node resection 4/21
New lung mets, Vectibix monotherapy started 6/21
Stop Vectibix lungs stable about 6 months; all other areas stable
Start Folfiri + avastin 1/22
Stop Folfiri (lungs stable 6 mos); start Vectibix 7/22
Stop Vectibix 12/22 (lungs stable 5 mos this time)
SBRT on lung Mets scheduled for 1/22, will restart Folfiri

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beach sunrise
Posts: 1027
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
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -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
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

Claudine
Posts: 808
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

Tumors: L4 04/18; left adrenal gland & small lung nodules 03/19
rectum 02/22 (pT3 pN0 stage 2A); L3 09/22

Surgeries: intestinal resect. 05/18 (no cancer - Crohn's); adrenalectomy 02/20
L3-L4-L5 fusion and corpectomy 05/20; LAR 04/22; ileo reversal 09/22
L2-L3 fusion and corpectomy 09/22

Treatments: EBRT 04/18; SBRT 02/19; Failed adjuvant Xelox ; Folfiri/Avastin 03/19 - 01/20
adjuvant chemorad (Xeloda) 06/22; SBRT 11/22; Lonsurf/Avastin 12/23

Claudine
Posts: 808
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

Tumors: L4 04/18; left adrenal gland & small lung nodules 03/19
rectum 02/22 (pT3 pN0 stage 2A); L3 09/22

Surgeries: intestinal resect. 05/18 (no cancer - Crohn's); adrenalectomy 02/20
L3-L4-L5 fusion and corpectomy 05/20; LAR 04/22; ileo reversal 09/22
L2-L3 fusion and corpectomy 09/22

Treatments: EBRT 04/18; SBRT 02/19; Failed adjuvant Xelox ; Folfiri/Avastin 03/19 - 01/20
adjuvant chemorad (Xeloda) 06/22; SBRT 11/22; Lonsurf/Avastin 12/23

boxhill
Posts: 789
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
5/20 MRI stable/NED
6/20 Stop Key
All MRIs NED

boxhill
Posts: 789
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
5/20 MRI stable/NED
6/20 Stop Key
All MRIs NED

jts
Posts: 58
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 down to 6. Cyst not visible anymore.
05/2023 CEA fluctuates between 4 and 6. Scans have been clear.

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beach sunrise
Posts: 1027
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
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -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
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

Brearmstrong
Posts: 112
Joined: Sun Mar 26, 2017 3:24 pm
Location: CT

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

Postby Brearmstrong » Fri Jun 11, 2021 5:00 am

Hi there, I don’t think you mentioned it but how is your CEA? Is that hinting that something is going on? You said MSK confirmed disease. Based on shape, appearance?

Brenda
50 F diag 1/17
Muc Adeno 4cm
mod diff G2 T4aN2
nodes 8/50
CEA 4.6 after surgery <.05
KRAS G12D MSS
FOLFOX Apr-sep 17
Nov 17 PET p aortic nodes Stage IV
Folfori w/avastin
May 18 surgery on nodes xeloda 2yr
Aug 18-May 20 NED
July 20 hysterectomy
July 21 vats right lung
Clinical trial- failed liver Mets biopsy shows now poorly differentiated carcinoma.
HAI pump at MSK may 2022
Nov met to pancreas- causing pain
Radiation ablation to pancreas Dec 22
New lung Mets watch and wait

Claudine
Posts: 808
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 » Fri Jun 18, 2021 1:37 pm

Well, it's now been 16 months since my husband's last Folfiri + Avastin cycle, and his lungs are still looking good: "Lungs, Pleura and Airways: Scattered calcified granulomata again noted unchanged. No new nodules identified". I hope yours disappear without treatment, prayingforccr, or that they're not mets in the first place, but if they are - know that systemic chemo can control them!
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A, no primary

Tumors: L4 04/18; left adrenal gland & small lung nodules 03/19
rectum 02/22 (pT3 pN0 stage 2A); L3 09/22

Surgeries: intestinal resect. 05/18 (no cancer - Crohn's); adrenalectomy 02/20
L3-L4-L5 fusion and corpectomy 05/20; LAR 04/22; ileo reversal 09/22
L2-L3 fusion and corpectomy 09/22

Treatments: EBRT 04/18; SBRT 02/19; Failed adjuvant Xelox ; Folfiri/Avastin 03/19 - 01/20
adjuvant chemorad (Xeloda) 06/22; SBRT 11/22; Lonsurf/Avastin 12/23

rp1954
Posts: 1849
Joined: Mon Jun 13, 2011 1:13 am

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

Postby rp1954 » Sat Jun 19, 2021 12:53 am

Our trials for alternative adjuncts' performance were faster, mostly around broad, sensitive blood work for us.
Some tissue work. Nonperformance has to be factored in, how to recognize it, and what to do about it soonest.
CEA may not be sensitive enough for your situation, alone (needs more series data at least for "noise" scatter) - my wife on her cancer treatment and low, baseline CEA had less CEA scatter than I do. Signal (meaningful CEA changes) to CEA noise ratio is important for detection and more informed decisions amongst blood panels. She had a lot of ant-inflammatories, from oral supplements to celecoxib and 1/4 aspirin to IVC. Imaging factors into the bloodwork too.

We would have rated your Tippens' protocol at least "insufficient" on the individual level and try to find another combination soonest, with or without the Tippens part.

Our alternative starting point after 8 yrs chemo is essentially chronomodulated oral 5FU chemo prodrugs, potent nutraceuticals, and celecoxib, then consider add-ons and observe responses across 6-12 blood panels for the cancer, and more for side effects, or side benefits. I am very impressed with 5FU compounds, in the right formulations, against most but not all CRC disease.
The thing is that -azole dewormers tend to be very harsh to combine with 5FU drugs, but not all dewormers are azoles (e.g. like IVM).

To us, the trick is to get enough punch to kill/damage/dissolve smaller mets, stop spread, and get advanced surgeries as necessary. In your case, the German laser lung treatment might be important to consider with better chemo. Conventional cyclic chemo treatments are too toxic for continuous treatment and most continuous regimes are too low powered without add-ons and changes. The add-ons are best targeted by some prior measurement, or observed for performance, or both.
watchful, active researcher and caregiver for stage IVb/c CC. surgeries 4/10 sigmoid etc & 5/11 para-aortic LN cluster; 8 yrs immuno-Chemo for mCRC; now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher, peaking ~2011-12, taper chemo to almost nothing mid 2018, IV C-->2021. Now supplements

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beach sunrise
Posts: 1027
Joined: Thu Mar 05, 2020 7:14 pm

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

Postby beach sunrise » Sat Jun 19, 2021 1:15 pm

Interesting for sure.
Keep us updated on the Tippens protocol. I hope it does the trick and scan is clear.
I take xeloda and ivermectin as part of my personal ADAPT+++, so far I have a great response. Scan on Friday.
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -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
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

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beach sunrise
Posts: 1027
Joined: Thu Mar 05, 2020 7:14 pm

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

Postby beach sunrise » Sat Jun 19, 2021 3:12 pm

Several small studies had success with IVM for anti-cancer is why I was interested. It is also very good for Covid too. A win win for me, protects me two ways in my opinion.
IVM is dr Rx and gotten thru a compounding pharmacy. Most likely you would have to go thru an alt dr (out of the box thinker) or plea your case with your current SOC dr and don't take NO for an answer but have papers to back you up with very nice attitude of "My Cancer, My Choice. Not yours or NCCN SOC." I end with "We will both sleep better at night knowing we tried our best for my benefit." For me, all my dr's know SOC is in the rearview mirror. Let's move on!!!
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -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
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

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beach sunrise
Posts: 1027
Joined: Thu Mar 05, 2020 7:14 pm

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

Postby beach sunrise » Sat Jun 19, 2021 4:13 pm

All of my decisions for Tx is based on my mutations really.
IVC is a great add on for kRAS mutant, proven over and over to combat it.
Do you have mutation(s)?
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -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
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

User avatar
beach sunrise
Posts: 1027
Joined: Thu Mar 05, 2020 7:14 pm

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

Postby beach sunrise » Sat Jun 19, 2021 4:42 pm

Yep, research and hammer the hell out of those mutations!
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -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
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test


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