I had my ct scan this morning. Dr. Martins emailed me the results this afternoon with the comment that they 'don't look good.' I am assuming that I am off the clinical trial.
* Preliminary Report *
~Examination:
CT chest, abdomen and pelvis with IV contrast.
Indication:
Non-small cell lung cancer. Restaging.
Technique:
CTB A15 Chest Abdomen Pelvis
Type of scan: Single phase spiral
Superior Extent: Lung apex
Inferior Extent: Ischial tuberosities
IV Contrast: Positive
Reformats: Coronal
Automated exposure control and statistical iterative reconstruction techniques substantially lowered patient radiation dose.
Comments: None
Comparison:
July 25, 2011
Findings:
Chest: Supraclavicular region: The necrotic left supraclavicular lymph node is essentially stable in size. It measures 2.4 x 2.5 cm (4/6)
previously measured 2.3 x 2.6 cm
Mediastinum: The necrotic conglomerate of lymph nodes in the AP window is not significantly changed in size. It measures 3.7 x 3.9 cm (4/28). Previously it measured 3.7 x 3.9 cm. Again the necrotic mass is encasing the left pulmonary artery.
New since the prior exam is significant left hilar adenopathy. The largest conglomerate of lymph nodes measures 1.8 x 2.3 cm (3/62)
Lungs: Multiple pulmonary nodules are again noted. All of the nodules are either stable or increased in size. New nodule is seen in the left lower lobe adjacent to the fissure and measures 4 mm in size (3/63).
Representative measurements are listed below.
The soft tissue density in the left lower lobe measures 2. 8 x 2.9 cm (3/85) is not significantly changed since prior.
Left upper lobe nodule measures 1 cm. (3/69) this previously measured 0.9 cm.
Right upper lobe nodule today measures 3 mm (3/24) previously measured 2 mm.
Right middle lobe nodule today measures 3 mm, (3/36) which is stable from prior.
Pleura: Normal
Heart: Normal
Abdomen:
Liver: Rounded hypodensity seen in segment 4B is stable from the prior exam. (4/72) This is too small to be characterized. 2nd
hyperdensity in segment 8 of the liver is also unchanged from prior exam this is too small to be characterized (4/51)
Gallbladder: Cholelithiasis without evidence of cholecystitis.
Bile ducts: Normal
Spleen: Normal
Pancreas: Normal
Adrenal: Normal
Kidney: Round hypodensity in the right kidney measures 9 mm in diameter (4/78), previously measuring 8 mm. Impression there is the
lesion has grown from 6 mm to 8 mm. The lesion measured 2 mm on March of 2011. This rapid interval growth is concerning for a metastatic lesion.
Bowel: Diverticulosis without evidence of diverticulitis
Pelvis:
Bladder: Normal
Uterus/Ovaries the wires cystic mass in the pelvis measures 11 x 13 cm (4/134) this is not significantly changed since prior
Lymph nodes: No retroperitoneal, pelvic or inguinal lymph nodes meet
CT criteria for enlargement.
Ascites: None
Bones: No suspicious focal lytic or blastic lesions
Vasculature: Normal
Impression:
1. Overall appearance of increase disease burden within the chest and mediastinum since the prior study
2. New left hilar adenopathy.
3. Necrotic lymph node conglomerate is stable from prior
4. Multiple pulmonary nodules are either stable or increased, and at least 1 new nodule since the prior exam seen in the left upper lobe
measuring 4 mm in size.
5. Small interval increase in size of the lesion in the right kidney since the most recent study, with a rapid increase in size when
compared to CT scan 6 months prior. This interval growth is concerning for metastatic disease.
6. Two hypodensities within the liver are stable. These lesions are too small to characterize.
7. The left supraclavicular necrotic lymph node is stable in size.
8. The cystic mass in the pelvis is also stable in size
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8 comments:
I am sorry to see this. Does this mean you will leave the clinical trial you have been in?
Sarah in Jerusalem
I'm very sorry to hear that the news is not what you had hoped for. Are there alternatives to the clinical trial?
We will keep you in our thoughts and prayers, Regina. Stay strong, keep up your spirits and fight the good fight as you always have.
Dan
Oh, Regina, I'm so sorry to hear this. When do you get to talk to the doctor about the next step? You are, as always, in my prayers. Hang in there!
Olive
It's pretty clear that I am off the clinical trial. My daughter thinks that the insurance company may not be willing to pay for a fifth line treatment, and there may be none out there that are of help to me. I meet with the oncologist at 8am Tues morning. So we will see then.
Regina I know this all sounds bad, but really from what I could read and from similar reports I typed in the past, most of it sounds stable. Obviously they don't like the lesion in the kidney, but that may or may not be a metastasis. Ditto hilar adenopathy, which could be nodes reacting to a viral or bacterial infection. It sounds like there are a lot of unknowns at this point. I read an article a couple of weeks ago about how vague CT scans can be, and how easily misread. I do have you in my prayers and do hope that you will get a bit more positive feedback when you meet with your oncology team. I hope my comments on this are not unwelcome. And overall, if you are feeling fairly well, please don't worry too much or get too down about this. Don't worry about approving my comment. I mainly wanted you to see it. Best to you always, Bonnie
A 8:00 a.m. Tuesday, there will be such a thunderous chorus of prayers reaching the heavens on your behalf! Keep up the battle, Regina!
Praying for a good plan for Tuesday morning. Bonnie
Regina, adding my prayers and hopes that on Tuesday there will be some good news re this trial or another clinical trial.
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