PET scan results

[NinjaJack]

Need some advice please.  I just received my PET scan results today and it says mass in upper right lobe 35mm x 19mm, 7.6 SUV.  Can anyone tell me what this means?  Thanks.

For reference I was diagnosed with melanoma last year.

[Tom Galli]

Jack,

The scan is suggestive of metastatic cancer.  Did you have a CT scan before your PET?

Here is some help understanding what a PET scan does and how it does it. If the scan showed only one mass, then my advise would be to engage a thoracic surgeon to see if the mass can be surgically removed. On removal, I'd also want the tissue biopsy to be laboratory tested for treatment applicability by targeted therapy and or immunotherapy.  Here is information about the special laboratory testing.

Was your melanoma successfully treated and eliminated? This mass could be a recurrence of melanoma in the lung. If it is melanoma, then the laboratory testing I mentioned will not be required and treatment, other than surgery, will follow protocols established for melanoma. I hope this helps. You are most welcome here.

Stay the course.

Tom

[NinjaJack]

Tom, 

Thanks for your quick reply.  The melanoma was stage 1 but my lymph nodes came back clear.

I just got the full report and it shows another spot in the left lower 19 x 21 mm with SUV 8.1.

The impression states:  Right upper lung and left lower lung opacities which are hypermetabolic as stated above.  Neoplastic versus infectious etiology.

[Tom Galli]

Jack,

Very likely there is a biopsy in your immediate future. So read into biopsies to prepare.

With masses in both lungs, surgery is not a likely treatment method. But, be sure to discuss the possibility of stereotactic body radiation therapy or SBRT. If it were me, I'd have a consultation with a radiation oncologist who administers SBRT in addition to a medical oncologist who develops chemotherapy treatment plans. SBRT can be as effective as surgery in eliminating tumors. And, I'd arrange that consultation with a radiation oncologist directly.  While the two oncology disciplines normally cooperate, they sometimes hold a bias towards their discipline's methodology. Here is information about SBRT.

Stay the course.

Tom

[NinjaJack]

Tom, 

Thanks for the advice.  I will have to try to get the AF Base to refer me to those oncologists so hopefully that will not take forever.  Wait, who am i kidding, of course they will take forever.

I am seeing a pulmonologist that did a bronchoscopy with a biospy but it came back clean.  So what type of biopsy would they be doing next?

 

Jack

[Tom Galli]

Jack,

A clean biopsy with tumors with high SUVs.  I can't understand how that would happen. Perhaps a CT guided needled biopsy.

You might inquire if the Warner Robins AFB docs can refer you to a VA medical center for the radiation oncology consultation. That might be the easiest path forward. Not likely many radiation oncologists at a base hospital.

Stay the course.

Tom

 

[NinjaJack]

Tom,

I've had several CT scans over the last 6 months that kept showing the 2 areas identified in the PET scan.  The lower left was defined on the last CT scan.  Even said possible metastatic lesion.  But the right side, the CT scans kept saying right middle lobe but would say stuff like possible lung mass or infection.  So when I was referred to pulmonologist all he did was an xray and didn't want to do anything else.  I asked to get a PET scan and he refused.  But he finally agreed to do bronchoscopy.  He decided to pull samples from the right middle lobe which came back saying no malignancy.  But the PET scan shows the mass is in the right upper.  So the 2 areas that showed up on the PET scan have not been biopsied.

I am seeing my oncologist tomorrow and I am hoping he will schedule the CT guided needle biopsy.  Right now I am just feeling very frustrated with the pulmonologist.  I feel like he is just waisting my time.  Even when the PET results came back he didn't want to even see me.  So I have a new referral to a new pulmonologist.  

Thanks for your help and advice.  Hope to get some answers soon.

 

Jack

[Tom Galli]

Jack,

I've found pulmonology to be a strange duck of medicine. They are really good at diagnosing and treating lung diseases other than cancer. With lung cancer, they get a little squeamish.  Once there is an indication of malignancy, I lean more to an oncologist for guidance.

Stay the course.

Tom