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Concernedson

Almost 2 years NED now suspicious cells in fluid

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My dad had stage iiia squamous cell nsclc in fall 2016....surgery to remove upper left lobe, one positive lymph node nov 16. January 17 multiple radiation/chemo treatments. Clean Ct scans since every 4 months. Had plueral effusion drained in summer 17 clean fluid with no cancer cells. Plueral effusion returned aug 18. Drained last week now doctor says "suspicious cells" wants PET scan. Dad also had afib and had cardiac ablation procedure in early Sept 18 where he had multiple chest CT scans in addition to regular 4 month scans....no tumors present. What could be causing a malignant effusion when no tumors on CT scan? If PET shows active areas what's next? Do they do chemo again?

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Concernedson,

Welcome here. 

I would think the effusion cells would be more conclusive. At least, that was my experience. The diagnosis standard is visual ID under a microscope and I would think a pathologist could be more specific. 

Perhaps his docs are looking for distant metastasis and therefore his PET. My only idea is a tumor or nodule growing in the scar tissue from his resection that is too small to distinguish on a CT. 

If the PET shows a single met, perhaps more surgery or precision radiation followed up by chemo. If the PET shows multiple mets, then likely chemo. Perhaps Taxol and Carboplatin or some derivation of these followed by immunotherapy. Or, maybe just immunotherapy if his PD-L1 marker indicates suitability. 

Hope I’ve answered your question. Hope the PET shows nothing. 

Stay the course. 

Tom

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