Should I be worried?

[Flyman35]

I will start with the fact that Tom is a 3 year stage 4 lung cancer survivor. The latest PET results from Friday have me worried though and I looking for opinions. We have a routine follow up appt with the Onc on 2/15 and are thinking of calling in the morning to move it up. The Pulm did not seem to like that that appt was still 3 weeks away.

The PET was ordered by the pulmonologist after a routine CT was marred by a bad case of pneumonia which landed Tom in the hospital for 5 days last month. The CT showed that the right hilum could not be evaluated due to the consolidation in the right lung from the pneumonia. The Pulm says to talk to the Onc and see if he thinks another round of chemo is warranted.

Findings show:

There is minimal faint increased activity associated with the soft tissue attenuation in the right hilum, SUV value less than 3. Although evaluation is limited without intravenous contrast, the soft tissue densities in the right hilum have increased by about 1 cm, superiorly presently measuring 3 x 4.7 cm compared to the prior 3 x 3.7 cm, and in the right infrahilar distribution presently measuring about 2.2 x 3.7 cm compared to prior 2 x 2 cm.

Impression:

Slightly more prominent soft tissue attenuation within the right hilum, but SUV values are less then 3. Findings are nonspecific, low to moderate suspicion for malignancy.

Very close CT surveillance of the chest is recommended.

Any insight would be appreciated.

Thanks,

Denise

[Annette]

My first thought was like Katie - ask over at Cancergrace.org. Seems suspicious that this follows a bout of pnemonia - there is usually some "swelling" and "activity" during a recovery period. Seems to me that they should redo the PET with contrast after a short recovery period (couple of weeks). The low SUV numbers as stated still indicate some activity and warrant another look as the doctor suggested. Like always it seems to be a piece of "hurry up and wait" - but we all know that patience gets us nothing here - I would try and get them to follow up the PET and check the SUV numbers since the doctor is already technically recommending another round of treatment.

Annette

[Joppette]

I think I agree with Annette and Katie too. 3 weeks seems like such a short amount of time, and yet it's not if you are worried about new growth. I was curious of the PET results that followed the CT.

I think you'll get sound medical advice at cancergrace too.

MI Judy