Results from CT-Scan (T Bones)

[Flo Bones]

We meet with the Onc on Friday to discuss the results of the CT-Scan taken last week. The scan was compared to that of Feb 7 (significant shrinkage). The CT Scan indicates the paratracheal mass continues to be STABLE in size. There is NO pleural or pericardial effusion. We are thankful!!!!!

Now this is where confusion creeps in. In Feb, Terry took both CT Scan and Pet Scan. The PET Scan indicated FDG uptake in enlarged right adrenal mass suggestive of hypermetabolic neoplastic disease most likely metastasis. However, nothing showed up abnormal on the CT Scan regarding his adrenal gland. The CT Scan he took last week revealed there is NO EVIDENCE of metastatic disease to the liver. The spleen, adrenal glands, pancreas are NORMAL. Conclusion: Stable CT of the chest and normal abdominal CT. No evidence of metastatic disease below the diaphragm.

My questions is: In your opinion, which scan is more accurate. The Onc seems to think the CT Scan is more reliable. He stated the Pet Scan sometimes has false readings.

Terry will be starting a more aggressive treatment on Thursday (I think it will be Carbo/Taxol). The Onc stated after three doses, we have an option to add Avastin to the treatment plan. I don’t know much about Avastin. I’ve researched Tarceva because it appears that most of you guys are on Tarceva. But the Onc said that Tarceva would not benefit Terry. Overall, we are thanking God for a good report.

I would appreciate any FEEDBACK on Avastin and the accuracy of CT Scan vs PET Scan. How can an uptake show up on one scan and not the other?

As always, thank you for your continuous support and prayers.

Flo

[Kasey]

I cannot address the Avastin question other than I know several here have had ~ and are still having great results with it. But as far as the CT vs. PET. I would go with the PET. Sounds as if it was covered pretty intensely with the CT scan ~ were you talking about the results of more than one CT ~ one previously and one just last week?. I showed no evidence of disease (NED) several times when the PET lit up. MY surgeon said if there is ANY type of inflammation that can happen. So with all my medical expertise ~ I concur with the CT. Sounds pretty darn good to me, Flo!

Kasey

[carolhg]

Hello Flo,

I am so happy to hear about the significant shrinkage of Terry's tumor. PET scans will light up for several different reasons. After my treatment of 6 weeks of chemo and daily radiation I had another PET scan. I had two lymph nodes to light up and I had a nodule in my left lung to light up. The lymph nodes we think lit up because of the radiation that I had received and we have no idea what made the nodule in my left lung light up. I had to have a biopsy on the nodule in my left lung before my surgeon would do the surgery. The biopsy proved the nodule to simply be scar tissue Thank God. During surgery my surgeon removed 18 lymph nodes and NONE of them contained cancer. I had an upper right lobectomy in July 2005 and by the Grace of God my scans have been clear since. I also was Stage 3A.

If the oncologist feels that the CT scan is more accurate why is he not preparing for surgery? You might want to get a second opinion. I send you positive thoughts and I am praying for you and remember we serve a Mighty, Mighty God!

Carol

[recce101]

Hi, Flo! Sounds to me like Terry has an excellent medical team and is doing very well. You might want to go to onctalk.com and ask Dr. West your questions about avastin vs. tarceva and CT vs. PET scans. You can expect a fast, authoritative, and understandable answer. In the meantime, I'll give you my opinion, or what I "think" I know.

Avastin has produced very good results with your husband's specific type of NSCLC, adenocarcinoma. A major risk with avastin is bleeding, which can occur if there are mets to the brain or if a tumor is next to a large blood vessel, but that is apparently not the case with Terry. Aside from that, the side effects from avastin are very minimal for most people (see my profile below). Tarceva has been wonderful for many patients, but less effective for people with a significant history of smoking.

CT scans produce very accurate, detailed images, sort of 3D slices from various angles of the area being studied. They are especially valuable when there is a previous CT scan of the same area available for comparison. A PET scan shows areas of increased metabolic activity (uptake) which can be caused by several things, only one of which is active cancer. PET images are rather fuzzy and do not show body tissue with any great detail, but a full-body PET scan can highlight areas of interest to zoom in on with CT or other devices.

That's about the extent of my "knowledge" as a patient since last September. Dr. West will say it better.

Best wishes to you both and Aloha,

Ned

[Ry]

It sounds like things are going in T's direction-- I love the word "significant", not just a little shrinkage but significant. My husband, John has had some amazing results with Avastin-- so I vote adding it in. John had been stable, then had some growth--after starting Avastin he had some shrinkage for the first time in a long time (see my profile).

[teriw]

Hi Flo,

Congratulations on the scans! I love reading good news. I know our radiation onc said that reading a PET is an art form, and I believe he thought they were about 85% accurate. Like others have said, there can be reasons other than cancer for spots to light up.

Hoping all goes well for T.

[fillise]

I can't answer your questions but I did want to add my consgrats for the "significant" shrinkage! WooHoo!

[mary colleen]

Flo,

Congratulations on the progress; it is very encouraging. My husband had a suspicious adrenal mass early in his diagnosis, and it has since "disappeared" - no longer shows up as metabolically active. There is a small mass on the adrenal, but it is considered to be a probable benign adenoma, which many healthy people in the general population have.

Again, many congratulations!

[mary colleen]

Flo,

Congratulations on the progress; it is very encouraging. My husband had a suspicious adrenal mass early in his diagnosis, and it has since "disappeared" - no longer shows up as metabolically active. There is a small mass on the adrenal, but it is considered to be a probable benign adenoma, which many healthy people in the general population have.

Again, many congratulations!

[trish2418]

Great news, Flo! I hope you continue to receive nothing but good news.

Trish

[Tom K]

Flo,

PET scans are capable of picking up inflammation, infection or cancer. In my case, a PET lit up an area on my liver. Because a CT and an MRI also showed some unusual tissue in that area of my liver I had to have a biopsy. It turned out to be just inflamed fatty tissue. The PET and MRI were redone 3 months later and the fatty tissue was still there at the same size but it no longer lit up on the PET. We accepted that has validation of the biopsy results. Terry’s doctor probably thinks it was just inflammation on his adrenal gland being picked up with the last PET. But you may want to ask him very specifically if he would consider another PET just to validate it was inflammation.

[alexan]

Flo congratulations, the treatment is working.

Best of luck

hugs & prayers

bucky

[needhope]

That's wonderful!! May God continue to bless you and your husband.

Rochelle