New MRI & PET Scan Results Are In

[Karen_L]

Today's MRI showed: "A new subcentimeter enhancing lesion is identified in the subcortical paramedian right frontal lobe, moderately suspicious for metastasis. The possibility of an isolated subacute lacunar infarct is also considered, given diffusion restriction associated with the lesion. Short-term MRI follow-up is recommended in 4-6 weeks."

Today's PET: "Hypermetabolic lesion in right perihilar region in the region of posttreatment changes. It is less conspicuous compared to prior PET from 2/26/2021 but persists. Multiple small right lower lobe pulmonary nodules are present but are distorted by motion.... There is a focal area of high metabolic activity in right perihilar region. SUV max in this region is 12.2. Previously, SUV max in this region was 20.4. Area of high metabolic activity is smaller compared to prior exam. Mildly increased metabolic activity, SUV max 3.9, corresponding to posttreatment changes in the posterior aspect of right lung. Background mediastinal blood pool activity: 2.6."

I see the oncologist tomorrow, the oncology radiologist Thursday; tumor board next Monday.

Three questions:

1. Have any of you attended your tumor board discussion? I've been told we can do this. Would you want to?
2. Could any of you send me to some research about the brain results? (The PET holds no surprises.)
3. Any thoughts about questions or comments *you* would bring to the upcoming appointments? 

Thanks.

Karen

[Tom Galli]

Karen,

I hoped you would have had better scan results. To your questions: I've not heard of patients attending a tumor board. Would I want to? No. I think all the medical lingo would just add to my fear and uncertainty. Better to have a doctor explain deliberations and results to me without the almost incomprehensible medical terms.

I don't have access to a library of research on brain mets. But I note you are consulting with a radiation oncologist. One of the most effective ways to deal with brain mets is precision radiation. Here is information on using radiation to treat lung cancer. You'll note that this information is extensively footnoted and some of these footnotes apply to treating brain metastasis. The best question you can ask of your radiation oncologist is can your very small brain met in the right frontal lobe be fried by medical radiation.

In addition to the ask for the radiation oncologist, I'd ask my medical oncologist if your current treatment is having the desired effect on your lung cancer. I note your SUVs are decreasing. Does that decrease indicate your systemic treatment is working or is it time to change to new therapy.

Stay the course.

Tom