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Regression of cancer - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Cancer
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3620 Questions
User :   My mother is currently 5 years in remmission after battling with Diffuse large B cell lymphoma. After her most recent PET Scan her findings are the following: " The FDG Pet images demonstrate moderate abnormal FDG activity associated with mild oropharyngeal muscosal asymmetry on the left which appears similar or slightly improved as compared to most recent prior. Peak SUV is increased, now measuring 5.7. Lateral to this FdG-avid oropharyngeal mucosa, there is moderate abnormal FDG activity associated with a stable level II A lymph node with increase in maximum SUV, now measuring 5.0. Additionally, there is increased moderate abnormal FDG activity associated with a stable level III lymph node on the left with maximum SUV of 5.1."
What does this mean?... Has her cancer come back? Any insight would be greatly appreaciated!
Doctor :   Hi,
User :   Hi
Doctor :   Please give me couple of minutes to read your post and help you well
Doctor :   Ok, to brief the report indicates the cancer regression
Doctor :   The SUV (Standardized uptake values) if is decreased is a good sign and indicates the regression of the cancer cells
Doctor :   Hence its preferred to compare the old pet scan reports with the post treatment one
User :   ok... shes never had this issue before in her neck. the prior PET scan in Feb. showed it to be smaller at 3.9 and now its 5.1
Doctor :   Yes, as the reports say the problem still persists in the neck nodes which is more expected
User :   Feb, 2010 Pet Scan... "the FDG images demonstrate resolution of mildly increased FDG activity seen in left level II A neck lymph nodes as seen on prior examination, However, the lymphadenopathy of the left level III neck lymph nodes is unchanged in size, but slightly increased FDG activity as compared to prior examination measuring peak SUV of 3.9"
Doctor :   since the other group nodes are not mentioned with increased SUV regression can be considered but neck nodal; involvement is aggregating
User :   In the most recent scan as of Aug 13th, the CONCLUSION states: Increased abnormal FDG activity in the left oropharyngeal mucosa, stable left level IIA Lymph node, and stable left level II lymph node is most consistyent with recurrence of disease.... does this mean she has lymphoma again?
Doctor :   Such presentation is expected with combined Chemotherapy and radiotherapy
User :   She was told to see ENT dr. ??? would her oncologist pick it up if it was cancer
Doctor :   Yes, for sure , the physical appearance is also very important in identifying the cancer regression or aggrevation
User :   wouldn't the PET scan show that?
Doctor :   Since the SUV activity can also be increased in many other inflammatory conditions
Doctor :   Its better to consult ENT once
Doctor :   NO, PET scan alone cannot completely rule out cancer
User :   could it be Lymphoma or some other type of cancer?
Doctor :   detailed physical examination is needed for the same
Doctor :   It could be lymphoma or a nonspecific inflammation
User :   by what i given you... do you feel it could be cancerous?
Doctor :   chances of it being other type of cancer is less likely
User :   nonspecific inflammation? this was first seen last August on her PET scan
User :   So you feel its lymphoma again?
Doctor :   May be
User :   When she was diagnosed 5 years ago it was in the abdomen area. could it reappear in other locations as lymphoma?
Doctor :   Yes,
Doctor :   Lymphoma can occur in any other areas where lymph nodes reside
User :   does the pet scan shows what stage it is at?
Doctor :   Yes, it could be commented by the radiologist reading the scan
User :   i have the scan here... what do i look for?
Doctor :   depending on the group and number of the nodes involved
Doctor :   A radiologist only can read the scan
User :   regarding her blood work... everything came back fine
Doctor :   Thats good
User :   wouldn't that pick it up?
Doctor :   still cannot rule out lymphoma completely
Doctor :   YES,
User :   what blood work would?
Doctor :   The differential count of leucocytes
User :   that wasn't on the list... only one i see close is lymphocytes, lymphocytes ABS
Doctor :   If you have planned for the next visit to oncologist ask for the test i mentioned
User :   i will... she has a sceduled ENT appt. first.
Doctor :   OK, thats fine
User :   thank you for your insight
Doctor :   Is there anything i can help you with ?
User :   no..Thank you
Doctor :   Thanks for consulting
Doctor :   Bye for now
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