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Scan time (updated)


francesbean

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Thank you so much for the kind comments, the prayers and concern. We have received the results today. It showed mild progression. :(

Here is the CT Report:

Comparison made to a previous study dated Sept. 27, 2005 again shows the multiple pulmonary nodules in the right lung base, some of which are about the hemidiaphragm showing mild interval progression in size. The largest measures 2.1 x 2.1 cm, (previously, 1.6 x 2.0). The tiny subcentimeter nodules in the right middle lobe are stable in size and number. The hyperdense / enhancing pleural based nodular density in the right apex is unchanged in size and appearance. A new pleural based pulmonary nodule is now demonstrated in the right apex measuring 1.2 x 1.3 cm.

The lobulated large anterior mediastinal mass with punctate calcifications is slightly bigger in size measuring 6.2 x 4.7 cm. (previously 6.0 x 4.2 cm). The marginal to small-sized lymph nodes in the prevascular space and AP window are unchanged. Small sized lymph nodes in the right hilum are the same. A small subcarinal lymph node is now noted.

Emphysematous changes in both upper lung fields are stationary. The atelectasis in the superior segment of the lower right lobe has slightly progressed.

There is slight progression in the pleural nodularity in the right posteromedial region. No pleural efflusion.

IMPRESSION:

OVERALL FINDINGS ARE INDICATIVE OF MILD DISEASE PROGRESSION COMPARED TO THE PREVIOUS STUDY DATED SEPTEMBER 27, 2005.

The onc explains that the progression might be because he has stopped taking Tarceva twice for two weeks each because of infections. The total of 1 month without Tarceva (From Oct. to Present) might have caused the progression.

She recommends Tarceva for another three months. Do you think this a proper prescription? Seeing as his main tumor grew about .2cm to .5cm, and his right nodule grew about .5cm x .1cm, and a new nodule measuring 1.2cm x 1.3 cm popped up.

Would you accept this treatment plan? I am confused. Thanks so much, your opinions are very much valued. (Will also post this in Ask The Experts.)

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Wow Hon,

I don't know if ANY of us have the expertise to comment on if the plan is a good one or not. Overall, the report (to me anyhow) does not seem all too bad. Especially since the doc noted that not taking the Tarceva could be the reason. It does seem some things have remained stable and that is a good thing. So not sure there would be anything else to do at this point - except see if resuming Tarceva may keep everything in check for the next scan.

See, I am no help.

How is Dad feeling? What does he think of this approach? That plays an important part here too.

I will be thinking of you both - hoping the right decisions will be made to beat this back once again!

Kasey

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Frances,

My husband's doctor has always switched drugs when there was progression. He says that the cancer adapts and changes to get around the drugs being used against it. Once there is progression, the same drugs aren't very likely to work. Just one opinion. Take care.

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  • 2 weeks later...

Thanks for the response, Tina. That is certainly something to think about.

I am bumping this post again in case someone has missed it the last time.

To make the story short, my dad has had progression while taking Tarceva from October to early January. Now the doctor said that the tumor growths might be because he got off the drugs for a total of 1 month due to his infections. She still advises to continue for 3 months, then scan again. I'm not sure if this is a proper protocol, do you think it's an acceptable treatment plan?

Thanks so much, for whoever has other answers or opinions to share. 8)

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I did miss it, Frances. I don't know that what I have to say will be helpful, though. May just present more questions...

When there is growth it usually indicates that the cancer has become or is resistant to the drug. Now, if all your Dad had was the 1 to 2 mm growth indicated by the .5 to .7 readings, then those might actually be explained by the CT scans themselves. Sometimes if the person is placed into the machine at exactly the same position as the previous scans then the "slices" taken can be up to 3 mm off. You could end up hitting a tumor in a different position, one where the measurement is larger. This happens more often than you might think. That's why I (now) make certain that my scans are done on the same machine at the same settings.

The thing that concerns me the most is the new mass, which is over a centimeter in size. That is not a Scanner issue. That is a new mass that is over a centimeter in size. I had one of those pop up in my left lung while I was on Tarceva. When the mass was removed it turned out to be a more aggressive form of Lung Cancer than my previous tumors, and it was obviously resistant to Tarceva.

I know this just adds more questions. But if your Father has a new tumor that grew in spite of Tarceva then it is probably time to look at other drugs or methods of treatment for that mass.

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Francis,

Sorry I was gone during this and missed these posts. I don't have answers either, but all of this raises questions. Three months is a long time to wait with progression...I'd keep asking questions too!

My prayers continue for your dad.

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