Recent Ct scan

[Tbaker]

This is my latest ct scan, it was

Just taken the 19th of August. My last one was just 30 days before and didn't look anything like this. Just looking for an opinion.

 

 

Ct scan 

 Lung cancer.

COMPARISON: 07/14/2020, 04/01/2018 PET/CT.

TECHNIQUE: Axial CT images of the neck, chest, abdomen, and pelvis are obtained after the administration of intravenous contrast. Mediastinal and lung windows were generated. Axial thick slab lung windows, sagittal and coronal MPR images were reconstructed as well. Iterative reconstruction technique and automated exposure control were used for radiation dose reduction.

FINDINGS:

CT NECK: The prevertebral and parapharyngeal tissues are intact and unremarkable. The parapharyngeal fat is preserved. The carotid space appears normal. There is no mass or adenopathy within the neck. The salivary glands appear unremarkable. The vallecula and piriform sinuses appear normal.

There are advanced degenerative changes of the lower cervical disc spaces. There is some prominent calcification of the dura on the right in the lower cervical spine.

CT CHEST: There has been marked worsening in the appearance of the chest. The mass in the right lung has increased to just under 6 cm. There has been further worsening of the extensive pleural nodularity and thickening. Greater involvement of the surface of the right hemidiaphragm inferiorly is noted. Subcarinal adenopathy has increased to 3.4 cm. There does not appear to be any direct involvement of the spinal canal or vertebral bodies.

Interstitial thickening throughout the right lung is noted consistent with lymphangitic tumor spread.

The left lung is clear.

CT ABDOMEN AND PELVIS: Within the right abdominal wall within the intercostal spaces adjacent to the liver there is some extension of soft tissue nodularity into the soft tissues. No new liver lesions are seen. The enhancing right lobe liver lesion is still nonspecific but is probably a hemangioma. The kidneys, pancreas, gallbladder, and spleen appear unremarkable. Loops of bowel are unremarkable. The uterus and bladder appear normal. There is no intra-abdominal or intrapelvic new mass or adenopathy.

Bony structures are unremarkable.
I'll see if I can find the last scan before this one.

 

[Tom Galli]

Tbaker,

Is this your Keytruda in process scan? Keeping up with everyone is challenging.

Of course, the lung situation is concerning. If you are on Keytruda, it is likely not affecting your tumor. One good news point is no mets anywhere outside the right lung.

I hope your med onc. has another approach in his treatment bag. Have you consulted with a radiation oncologist to determine if zapping the areas of concern in your right lung is possible?

Stay the course.

Tom

[Tbaker]

This was taken after my 1st keytruda infusion. I had my first 4 chemo treatments with keytruda. There was a small (tiny) increase in the ct scan after my 4 chemo treatments. This scan I just posted was 30 days afterwards.

I'll find out what the plan is this Thursday. 

Doc did put me on prednisone for inflammation.

To be honest I'm pretty scared.

[Tbaker]

I will fight this with everything I've got. 

[BridgetO]

Hang in there! 

Bridget

[LexieCat]

That report would scare me, too. Hope you get to meet with your oncologist soon and find out what this means and where you go from here. 

 

 

[Tbaker]

I see him this Thursday. I dont know how within maybe 3 week we get to this point. My last ct showed just a slight increase. And I still felt pretty darn good. My oncologist said it was more than likely inflammation.,To this? Doc has put me on prednisone for now. Gosh,I feel like I should go pay for my cremation expenses. 

[Deb W]

I understand your worry.  I hate it when they release these reports without comments from the oncologist.  Good luck on your appointment with the oncologist Thursday - maybe he/she will have another treatment plan.

Deb

[Tbaker]

He did tell us at our 1st meeting that if plan A doesn't work out we always have a plan B. 

I sure hope so.

I'm scared for my family. My 85 year old father lives with us and I worry mostly about what this is doing to him and his health. 

I need to stop looking at these scan reports before seeing him. 

[Tom Galli]

Tbaker,

As a civil engineer, I found my attempts to practice medicine failed miserably. But I completely understand Scanziety, scans showing tumor growth, recurrences and the like. I know what you are feeling. I've been there. Here are a couple of suggestions moving forward.

First, try and live in the day. When I was in my recurrence--chemo--recurrence cycle, trying to imagine a future did nothing but cause dark feelings. I learned to avoid that fear by looking for the expiration date stamped in my forehead in the mirror each morning. If there was no stamp, I enjoyed my day.

Next, focus on you. As a mom and caregiver, you've already got a full plate. Find ways to scrape a bit off. Try to find space and time to relax and de-stress.

Last, remember many of us have been where you are right now and many of us are still around. So there is always hope! if I can live, so can you. Hold that fact in your mind as you contemplate consultations and treatment.

Stay the course.

Tom

[Lin wilki]

My scans are never posted until After I’ve met with my onc for results. A good thing for sure!  I’m sure there will be another plan if needed. At least you will learn if there are reasons for concern and putting in a new plan

My first PET scan after 6 months on immunotherapy trial showed much progression. I did not know that until my appointment and the new (chemo) plan was already in place for that day. Hit me like a ton of bricks but glad things already decided for me!  
My last post says how upsetting the scan reports are — so better not to read them!  Just listen to your doc

Good luck and follow up

 

[Tbaker]

1 hour ago, Tom Galli said:

Tbaker,

As a civil engineer, I found my attempts to practice medicine failed miserably. But I completely understand Scanziety, scans showing tumor growth, recurrences and the like. I know what you are feeling. I've been there. Here are a couple of suggestions moving forward.

First, try and live in the day. When I was in my recurrence--chemo--recurrence cycle, trying to imagine a future did nothing but cause dark feelings. I learned to avoid that fear by looking for the expiration date stamped in my forehead in the mirror each morning. If there was no stamp, I enjoyed my day.

Next, focus on you. As a mom and caregiver, you've already got a full plate. Find ways to scrape a bit off. Try to find space and time to relax and de-stress.

Last, remember many of us have been where you are right now and many of us are still around. So there is always hope! if I can live, so can you. Hold that fact in your mind as you contemplate consultations and treatment.

Stay the course.

Tom

Thank you. I will take your advice. I have to do something or I'll drive myself insane. 

[Rower Michelle]

I agree with Lin,  fortunately my results are not posted until a few days after my appointment too.   One of the things we learned over the weekend at the Lungevity Survivors Conference was that there are now more than 30 different treatments available for lung cancer.   It's not a one size fits all approach anymore.  Oncologists start with the standard of care as outlined in the NCCN guidelines as a first line even though there are other effective treatments available. 

The key is understanding why the first attempt was not successful, that lies in the pathology report.  One of the questions I would consider asking is whether or not the oncologist plans to do a re-biopsy.  Sometimes the tissue needs to be sent to a different lab for another round of  biomarker studies.   I would also ask about a liquid biopsy (aka blood biopsy), sometimes that can yield quicker results. 

I try not to think about treatment as a plan b approach, from my perspective it's kinda like Google Maps when I go home to Jersey, it tries to tell me to go one way, but I'm a life long local and know the back way with the least number of traffic lights.    The next treatment plan is like taking the back way to your destination, you will get to where you're going by taking a different route that works for you.  

One of my friends here in KC is a 14 year survivor, she's had numerous lines of therapy, none of the traditional first line therapies worked for her, and yet she's still here, large and in charge.  As Jean-Luc Picard would say: ENGAGE.....   Hang in there. We're rooting for you. 

Michelle 

 

[Tbaker]

Thank you. I definitely will be asking my oncologist these questions.