nodule on lung and PET/CT scans

Lee C · New User Joined: 19 Sep 2007 Posts: 2

Quick history: Stage 4 metastatic melanoma. Melanoma first appeared on side of nose in 1999. Resected and no chemo given. Had not spread to lymph nodes based on sentinel node biopsy. Flash forward to Feb of 2006, tumor found in brain and resected turns out to be melanoma. Surgeon got the whole tumor but they shot the tumor bed with gamma knife radiation and give me Temodar to take for the next 7 months despite the fact that CT and MRI scans showed no spread of the disease. Doctor determined it was the best course of action for preventative reasons. Months later I visited another doc for a second opinion and he said he would not have put me on Temodar since there is no way to measure if it is working since I had no measurable disease. In any case I have been tumor free for 18 months or so I thought until last month.

In july of 06 they found a non-calcified nodule on my lung using the standard CT scan of which I have been on a schedule of getting these scans every 3 months. They watched the nodule carefully and it remained stable till the July CT scans of 2007. At the July 07 CT scan they noticed some slight growth measurement was 9mmX11mm. He thought they may want to biopsy but radiology, who does they biopsy, thought is was smallish and suggested rescanning in 6 weeks to see if it grows anymore. They were planning on another CT but my wife and I asked for a PET/CT scan. My oncologist did not want to do it and when we asked why he said due to false positives. We asked him to order one anyway. 6 weeks later results came back as positive for the nodule in the lung meaning there was moderate metabolic activity in the nodule shown from the radioactive glucose they shot me up with. The report also showed it now measured 8mm so apparently there was some shrinkage. Now the oncologist has referred me to a thoracic surgeon.

I have some big concerns about getting a lobectomy. I have had some people I know who are in the melanoma research area that have said don't do anything. Melanoma can sit in your body for many years and not grow. On the other hand melanoma can move thru your lungs like a wildfire. In my case it has done nothing until recently and even the radiologist report from July 07 CT scan said it exhibited characteristics of a hammartoma which can expand and contract. The oncologist nurse told me that a benign tumor can also show metabolic activity in a PET scan (false positive). If I had not demanded a PET scan I wouldn't even be writing this now as the oncologist would have told me that there was no growth and we should just continue to monitor every 3 months.

Anyone out there have a similar experience with PET scans? I welcome any comments or suggestions as my appointment with the thoracic surgeon for the initial consult is Thursday 9/20/07.

brainman

Hi Lee,
You have been through a lot since 1999!! I am very sorry you are now facing another major surgery. Have they tried to do a less invasive form of biopsy first? It would be a shame to have a lobectomy only to find the it is a benign tumor. PET scans do have the danger of false positives but are pretty good at detecting metastatic growths.

You are in my thoughts and prayers as you make this very difficult decision.
_________________
Jim
Site Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendoglioma grade 3, same location.
My Story Part 1: http://cancerforums.net/viewtopic.php?p=7350
My Story Part 2: http://cancerforums.net/viewtopic.php?t=8029
Blog http://jimhawkinsport.blogspot.com/

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