PET scan, finally...

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Claudine
Posts: 582
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

PET scan, finally...

Postby Claudine » Thu Dec 16, 2021 1:30 pm

After many CT scans showing nothing, but a high CEA, DH finally had a PET scan. Results just got posted. Main findings:

+ New hypermetabolic focal nodular wall thickening in the left posterior upper rectum concerning for underlying neoplasm or polyp. Recommend colonoscopy for further evaluation.

+ Large right L4 lytic lesion status post instrumentation and fusion at L3-L5. This is overall similar in appearance to prior CT exams, however there is associated peripheral nodular FDG uptake for which residual or recurrent disease is not excluded.

+ No other abnormal areas of FDG uptake or evidence of metastatic disease.

Meeting with onc scheduled for the 22nd. I guess we'll see what he's got to say - probably not much until DH has a colonoscopy and they know exactly what we're dealing with. While I of course wished for a completely clear scan, I was also worried it may be a lot worse. Hopefully DH isn't too upset by these findings and manages to relax during the holidays. Never a dull moment...
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: high 81.1, low 3.2, now 51
Scan 03/19: Multiple small lung nodules, now gone/calcified
L3-L4-L5 fusion surgery and partial corpectomy 05/20
PET 12/17/2021: uptake in upper rectum, colonoscopy next

Claudine
Posts: 582
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: PET scan, finally...

Postby Claudine » Thu Dec 16, 2021 1:41 pm

At least it's upper rectum and doesn't seem to be very large (if I'm reading this right?). That's a better place for surgical removal than closer to the anus, isn't it?
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: high 81.1, low 3.2, now 51
Scan 03/19: Multiple small lung nodules, now gone/calcified
L3-L4-L5 fusion surgery and partial corpectomy 05/20
PET 12/17/2021: uptake in upper rectum, colonoscopy next

MadMed
Posts: 79
Joined: Sun May 02, 2021 5:52 pm
Location: Massachusetts

Re: PET scan, finally...

Postby MadMed » Thu Dec 16, 2021 3:26 pm

I think so, at least you have a good chance of getting it reconnected. A rectal cancer patient with me in radiation is getting just the tumor part removed and gets to keep the rest of the rectum. In his case, it was really high up. I hope it works out the same for you.
52M DX: RC lower rectum, guessing now 2cm from AV 4/27/2021
T3N0M0 adenocarcinoma with signet ring cell features
Tumor size 30mm
Tumor grade: G3
Baseline CEA 1.0
MSI status: MSS pMMR
Started Folfox 5/12/2021
Switched to FOLFIRINOX from session 2. 8 rounds total.
CT+MRI tumor contained shrunk 80%, no spread to other organs.
CRT started xeloda + 28 days Radiation 9/27-11/04
surgery postponed until after 2/23 sigmoidoscopy

Claudine
Posts: 582
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: PET scan, finally...

Postby Claudine » Thu Dec 16, 2021 4:02 pm

Thanks MadMed! I guess I'm putting the cart before the horse, since we're not sure exactly what's there, but with an SUV value of 11.9 I can't really imagine that it's something benign. But I believe DH will prefer the notion of surgery over more chemo.
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: high 81.1, low 3.2, now 51
Scan 03/19: Multiple small lung nodules, now gone/calcified
L3-L4-L5 fusion surgery and partial corpectomy 05/20
PET 12/17/2021: uptake in upper rectum, colonoscopy next

stu
Posts: 1549
Joined: Sat Aug 17, 2013 5:46 pm

Re: PET scan, finally...

Postby stu » Fri Dec 17, 2021 1:43 pm

Hi,

Hopefully they will be able to get onto the uptake issue in the colon . I know you have been concerned for sometime about the higher CEA and sounds as though you have been correct . However the benefit of this is quick intervention and resolution. As much as I hated my mum requiring more surgery the last met was removed with no further chemo and never been a problem since .
Hope your husband is coping ok. Tough having to face up to more intervention but on the whole it looks as though there would be solutions and that’s got to be a good thing !
Thinking of you both .
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

Claudine
Posts: 582
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: PET scan, finally...

Postby Claudine » Fri Dec 17, 2021 2:00 pm

Always so uplifting, Stu :D
Thank you! We went to see a local jazz group last night, that was the best thing to do to take DH's mind off the results :)
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: high 81.1, low 3.2, now 51
Scan 03/19: Multiple small lung nodules, now gone/calcified
L3-L4-L5 fusion surgery and partial corpectomy 05/20
PET 12/17/2021: uptake in upper rectum, colonoscopy next

stu
Posts: 1549
Joined: Sat Aug 17, 2013 5:46 pm

Re: PET scan, finally...

Postby stu » Sat Dec 18, 2021 4:32 am

Claudine,
My mum is now doing research into long term survival. They are looking at her tumour samples to see if she possesses some form of protein. Something to do with natural killing T cells ! Apparently boosted by exercise , music therapy etc . I have no idea regarding the science but my mum was at complete peace following her diagnosis and concentration fully on her well being. Makes you wonder .
Getting the blood samples to them is proving tricky with covid but we will find a way !
Best foot forward as my mum likes to say .
I was thinking of all the cycling your husband does !
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

Claudine
Posts: 582
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: PET scan, finally...

Postby Claudine » Sat Dec 18, 2021 4:51 pm

My mum is now doing research into long term survival.


That’s so interesting, Stu! Please keep us posted on the findings!
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: high 81.1, low 3.2, now 51
Scan 03/19: Multiple small lung nodules, now gone/calcified
L3-L4-L5 fusion surgery and partial corpectomy 05/20
PET 12/17/2021: uptake in upper rectum, colonoscopy next

Claudine
Posts: 582
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: PET scan, finally...

Postby Claudine » Wed Dec 22, 2021 9:12 pm

DH met with his onc today. As expected he's recommending a colonoscopy, but since the CEA is still dropping (now at 51), and everything else is stable, he doesn't seem to be too worried. I guess we'll take it as a positive!
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: high 81.1, low 3.2, now 51
Scan 03/19: Multiple small lung nodules, now gone/calcified
L3-L4-L5 fusion surgery and partial corpectomy 05/20
PET 12/17/2021: uptake in upper rectum, colonoscopy next


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