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Cancer patient. Tried FNAC. Ultrasound indicated metastatic carcinoma cells. Cancer spread to lungs and heart. Suggest?

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Practicing since : 2004
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Hi Doctor

I have been asking you for guidance for my mother's cancer treatment earlier. Last XXXXXXX doctors tried to do FNAC test but doctors could not pull out cells, only blood came out. Doctor sent her back home suggesting a follow-up after 2 months. in August when she went for a follow-up check-up, she underwent Ultrasound, FNAC of neck, which indicated metastatic carcinoma cells. Doctors advised chest X-ray and PET scan which gave the impression that her cancer had spread to heart, lungs and spine.
Doctors have given up now and say she has only 3 to 5 months.

We went for a 2nd opinion and this doctor feels that it is highly unlikely that it can spread so fast, as he had seen her chest xray reports. Now, he suggests an HR CT scan and biopsy of lung and bone.
Attaching her reports for your kind perusal. Please let me know what you think sir.

Posted Mon, 14 Oct 2013 in Cancer
Answered by Dr. Indranil Ghosh 14 hours later
Brief Answer:
Appears to be disease spread

Detailed Answer:
Thanks for your query. I am sorry to know about your mother. Though it is unfortunate, the PET-CT report strongly suggests spread of the disease. The uptake values in metastatic sites are quite high. The FNAC form neck node is also positive.

Did she undergo radiation after surgery? if so, then there is no point going for biopsy of lung and/or bone. Because we cannot radiate the neck again. If she did not receive radiation earlier, then we can do these biopsies just to confirm that it has spread beyond the neck and there is no point of giving RT.

Otherwise, if she is fit, we can give chemotherapy +/- an antibody cetuximab to control the disease for a few months. Expected survival is not good in any case.

Hope I have answered your query. I will be available to answer further followup queries, if any.
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