How to find lung cancer stage

[Hariharan]

Hello All,

I'd like more information about how to identify and find lung cancer stage?

my sister is 27 years old and CT scan showing below info:

intensely hypermetabolic left lung upper lobe nodule noted , measuring 2.3x2cm with an SUV max of 6

mildly hypermetabolic  bilateral pulmonary nodules noted, largest measuring 1.5cm with an SUV max of 3.2 

The doctors took a wait and impression its lung cancer stage 3. could you please suggest identify and find lung cancer stage. i have also attached the report 

Regards

Hari

[Tbaker]

My understanding is....that stage 3 is that it is contained within the lung and has gone into the lymph nodes. It has not spread into other organs, bone spine, brain or blood. I could be wrong but that's my understanding. 

[Tom Galli]

Hari,

It is difficult to read your reports because I can't rotate them to the portrait orientation. But, I note your sister had a PET scan not a CT scan. Here is an explanation of the difference.

PET results are designed to show areas of the body exhibiting high metabolic activity. Cancer cells have metabolic rates far higher than normal cells. Therefore, when the radioactively tagged glucose, the test agent for the PET, is observed, the radiologist sees areas of metastasis light up or brighter than other cells in the body. This brightness is called a Standard Uptake Value or SUV. There are a lot of variables associated with SUV results. Inflamed areas from recent illness display elevated SUVs. Some small metastatic tumors don't show an SUV value. So consider that I am not a radiologist and the aforementioned SUV variability in the following discussion.

SUVs above 3 are likely metastatic (cancer). Your sister's 2.3 x 2cm nodule in the left upper lobe is likely metastatic with a SUV of 6. The mildly hyper-metabolic bilateral pulmonary nodules cited have a SUV of 3.2. Bilateral implies two and their locations are not detailed in the report. The largest was reported at 1.5cm and this is a very small nodule and these sometimes don't reliably show uptake. If they are lymph nodes, the elevated SUV may be attributed to fighting a recent infection, but given the reported upper left nodule, they are likely metastatic.

The report further indicates the presence of pericardial effusions in the left and right pleura. No SUV is reported for this indication but the impression characterizes the effusions as metastatic. Pleural effusions can result from the body fighting an infection or from the presence of metastatic cancer in the lungs. Most concerning however in the impression portion of the report is: "multiple intensely hyper metabolic sclerotic skeletal lesions, consistent with metastasis." This means bone metastasis and although an SUV is not cited for these, bone metastasis along with a primary tumor in the upper left lobe, and the pleural effusions the radiologist reported as "consistent with metastasis" would normally stage as IV. Here is an explanation of lung cancer staging.

Do keep in mind that I am not a doctor and you didn't show the full report. So I could be wrong but I think you should ask further questions of her doctor to confirm the PET results. I don't understand what you mean by "the doctors took a wait". If it means the doctors are going to wait a while and rescan, then if it were me, I'd be pressing for a biopsy. Only a biopsy of suspicious areas can confirm the presence of cancer and biopsy results are necessary to devise a treatment plan. Here is information on lung cancer biopsies. 

Don't hesitate to ask further questions. That is the purpose of this site and although we are not doctors, we have a substantial amount of "on the job" experience as lung cancer patients.

Stay the course.

Tom

  

 

[Tbaker]

Thank you for your help 🙂

[G.A.M.]

I know mine is Stage IIIA. I'm waiting not so patiently to get the prescribed chemo, but COVID-19 keeps getting in the way.