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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for tumors in mediastinum and liver

I am a 65 year-old woman in good condition. I was diagnosed in 06 with mid-gut carcinoid (neuroendocrine cancer.) Tumors were removed from omentum, root of mesentery, ovary, small bowel, peritoneum, bladder, rectum, 10 or 12 lymph nodes were positive for carcinoid. I have been on continuous infusion pump of octreotide acetate for three years. I had three rounds of 177-Lutetium ending in March of this year (2010.) I still have small tumors in the mediastinum and liver. Most are not metabolically active according to recent PET and MRI. But I know this is just a reprieve. What course should I seek in the future? At what point should I do this?
Tue, 7 Jul 2015
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Pulmonologist 's  Response
Thanks for your question on Health Care Magic.
I can understand your concern.
Neuroendocrine tumours are known to affect mediastinal lymphnodes, live, lung etc.
So better to get done PET scan every six monthly and see the size and number of hot spots.
Hot spots are due to increased uptake of PET dye. And this suggest possibility of malignant lesion.
So if your PET scan show larger uptake or increased in the number of lesions than these suggest worsening of neuroendocrine tumour and hence you need remission chemotherapy.
So consultation with oncologist and PET scan every six monthly are required in your case.
Hope I have solved your query.
I will be happy to help you further.
Wish you good health. Thanks
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