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Author |
Topic: CT Scan Questions |
TammiW
Member
Member # 109
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My 49 yr. old sister had surgery May 7 at MDA/Houston for
cancer on her upper palate. She finished radiation on Aug.
9 and it still quite ill from it all. Most recently she acquired
an infection which has affected her mouth, eyes and ears.
Treatment has been antibiotics, steroids, eyedrops and eye
washes, plugs in her tear ducts and I can't remember what
else. The results of her recent ct scan show "something" which
has scared us to pieces thinking that the cancer has returned.
From what I've read here today it could possibly be scar tissue
or swelling caused from the radiation. She has another scan
scheduled for next week. What does a second scan mean?? Is
this followed up with a biopsy?? What are the chances it is
only radiation-damage that is showing on the scan?? Guess
what I am asking is, is it more likely it is cancer showing
up? We are all very frightened. Thank you. Tammy W.
Posts:
5 | Registered: Apr 2002 |
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Brian
Hill
Administrator
Member # 4
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Either could be the right answer. Infections after treatment
are common, your immune system is beat to death by all of
the treatments and every opportunistic bug, fungus, or virus
wants a piece of you...and you have little left to fight them
off. For me it was one thing after another for the better
part of 6 months. I was always on antibiotics for something,
then on antifungals for the blooms of Candida that the antibiotics
let happen. I got every virus that went around, in spades
compared to regular people that got it.
CT scans while they show changes in tissue mass, cannot diagnose
cancer; only a biopsy can give you a definitive answer. CT
scans will also show changes resulting from the treatments,
including in my case nodes which were positive in the CT but
after surgical removal proved to be cancer free...zillions
of rads of radiation will kill the cancer, but to a CT scan,
it can't tell if the cancer is alive or dead, just that the
node is not normal. The tissues after treatment are certainly
not normal, there is lots of swelling and other changes that
the CT can not interpret.
Try not to get too upset about all this until there is a finite
answer at hand. From my own experience and that of many that
I talk to, that first year after treatment is full of surprises,
most of them not cancer. This doesn't mean you are out of
the woods, just that there are plenty of non-cancer things
that could yield these kinds of problems.
--------------------
Brian, stage 3 oral cancer survivor. OCF Founder and Director.
"The first responsibility of a leader is to define reality.
The last is to say thank you. In between, the leader is a
servant."
Posts:
368 | From: Laguna Beach, CA | Registered:
Mar 2002 |
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CynthiaS
Senior Member (75+ posts)
Member # 161
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Tammy,
I'm with Brian - don't get scared until you have a reason
to be scared. One of the side effects of cancer is paranoia
- always thinking an ache or pain or patch of something is
the cancer returning. This is a common and normal reaction
and should lessen as time of being cancer-free continues.
Be thankful your sister has a doctor who is following up on
an inconclusive scan. Some would just dismiss it. We have
to remember that the diagnostic tools used are not 100% and
sometimes it is difficult to know definitively what they are
seeing. They are not sure whether they are seeing cancer cells
or effects of radiation in my mother's lymph nodes - but they
want to do a neck dissection to be sure.
Try to be positive - why not be the voice of reason in your
family and set the tone for your other family members. You
will be helping yourself and your sister.
Best wishes,
Cynthia
Posts:
79 | From: Florida | Registered: May
2002 |
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kcdc
Platinum Member (100+ posts)
Member # 307
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Cynthia raises and excellent point about how previously calm
rational people can become paranoid to the point of feeling
like a psychiatric diagnosis is in order! I think we should
include all caregivers and partners in this statement as well.
Living with the "worry factor" is constant and at times overwhelming.
On a practical note, I would suggest someone go with your
sister when the results are reviewed and ask the MD's to SHOW
on the comparative scans what they are seeing, and offer an
explanation. I would cross-check a surgeon's explanation against
a radiation oncologist's and vice versa. If there is any doubt
or big debate, ask if her case can be presented at tumor board
and have her(and a trusted someone else) attend to hear the
debate. If this is not allowed, ask for a representative from
each speciality to meet with you.
Best of Luck,
Kim
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kcdc
Posts:
127 | From: Boston, Ma | Registered: Aug
2002 |
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digtexas
Platinum Member (100+ posts)
Member # 320
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Brian,
Your post here was very helpful to me. The docs don't feel
any nodes in the neck but the CT scan did show one little
bit of something. They have scheduled me for an ultrasound,
and, if needed later, a biopsy will be done. The Dr. did not
explain to me all that well what is happening, but your explanation
in the post made me feel better as you suggest that there
is a strong likelihood that the stuff shown on the CT scan
is dead. Thanks.
Danny
Posts:
112 | From: Houston, Texas | Registered:
Sep 2002 |
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Brian
Hill
Administrator
Member # 4
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Glad to be of help when I can. It is a pretty simple procedure
for them to do a fine needle biopsy of the node in question.
A few needle insertions in a variety of areas in the node
should give them representative samples of cells that can
then be looked at by a pathologist. If something is still
there, you will know in 3 days. My surgeon decided not to
take any chances, and just went in and did the modified radical
neck dissection and took them all. I had multiple positive
nodes before radiation bilaterally. They still showed up on
the post radiation CT scans. The pathology report on all the
removed nodes was negative, but I don't regret his being extra
sure by putting me through the surgery. This example is a
good demonstration that scans cannot detect cancer. Surgery
was the easiest part of the treatment overall, a cakewalk
compared to the 8 months after radiation.
--------------------
Brian, stage 3 oral cancer survivor. OCF Founder and Director.
"The first responsibility of a leader is to define reality.
The last is to say thank you. In between, the leader is a
servant."
Posts:
368 | From: Laguna Beach, CA | Registered:
Mar 2002 |
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kcdc
Platinum Member (100+ posts)
Member # 307
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Hi Danny:
Here is the update about you I've been looking for...good
luck with the ultrasound and biopsy if it comes to that.
I agree with Brian-Dave thought the neck dissection was as
okay as surgery can be and was out of the hospital within
a week. If you end I needing to consider this procedure, we
can share every detail!
The doctors at Mass Eye & Ear here (also a major head & neck
center) also let us know clearly that scans done post-radiation
can be tricky to interpret and surgery more complex to perform
because radiation changes the landscape of the oral cavity
and neck tissues so much. This information continues to validate
the need for expert eyes to be reviewing cases. Luckily, you
are also at a major U.S. H&N center so that is good news!
I'm wondering if your case can be presented at tumor board
rounds for review and update so many eyes can weigh in with
an opinion about the latest CT? I agree with Brian about the
biopsy...I would advise Dave (and hound his docs) to do the
same if there is any question).
Keep us posted,
Kim
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kcdc
Posts:
127 | From: Boston, Ma | Registered: Aug
2002 |
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Meredith
Member
Member # 315
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Brian
My husband John completed a similar course of treatment. His
surgeon removed the nodes after radiation and chemo. The path
was negative. He does not regret the decision to remove the
nodes. Unfortunately, the surgeon was not able to remove the
nodes without taking the jugler vein and trapesious muscle.
John is having a very difficult recovery from this surgery.
His throat is still swollen (surgery was two weeks ago). Any
suggestions as to time involved in healing??
Meredith
Posts:
19 | From: Summerfield, Florida | Registered:
Sep 2002 |
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Brian
Hill
Administrator
Member # 4
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While my surgery was significantly less involved than your
husbands, it still took me the better part of a month to get
past the discomfort, and it was another two months before
the lymphedema swelling started to go down. Given the extra
structures that were removed in your husbands case, I believe
patience is going to be the operative word here.
--------------------
Brian, stage 3 oral cancer survivor. OCF Founder and Director.
"The first responsibility of a leader is to define reality.
The last is to say thank you. In between, the leader is a
servant."
Posts:
368 | From: Laguna Beach, CA | Registered:
Mar 2002 |
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Meredith
Member
Member # 315
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Brian
Thanks for the response. John really looks for your input.
meredith
Posts:
19 | From: Summerfield, Florida | Registered:
Sep 2002 |
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digtexas
Platinum Member (100+ posts)
Member # 320
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Geez,
After reading about these operations, I hope that the Dr.
will be satisfied in my case with the ultrasound and possibly
needle biopsies...You guys scare me. I don't think I want
no stinkin neck dissection!! I have been lucky so far that
none of my treatment has been disfiguring. I surely hope that
I can keep it this way.
Danny
P.S. Best of luck to those recovering from surgery
Posts:
112 | From: Houston, Texas | Registered:
Sep 2002 |
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Brian
Hill
Administrator
Member # 4
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Dear dig, obviously for all of us ensuring that we got all
the cance is the number one priority. But even an old duffer
like me had thoughts about the consequenses esthetically of
having a neck dissection. I guess vanity knows no bounds....
But I can tell you, and you can see from my picture in my
profile here or in the founders story in the people section
of the main site, that though missing a good chunk of the
right side of my neck, the final result isn't that ugly. In
fact most people don't really notice it until they really
get a close look at the foot long scar. There are different
types of neck dissections which remove differnet amounts of
anatomical structure. I had a modified radical neck dissection,
which left the majority of the muscle mass intact. This is
the most conservative of the choices, and primarily removes
fatty tissues and nodes. I'm happy with my choice, and the
added feeling of security that it gave me to get everything
they could. And the vanity part, well you just get used to
it, besides as Ingrid tells it, as you get older your eyes
begin to go, and those wrinkles and scars really aren't that
obvious anymore.....
--------------------
Brian, stage 3 oral cancer survivor. OCF Founder and Director.
"The first responsibility of a leader is to define reality.
The last is to say thank you. In between, the leader is a
servant."
Posts:
368 | From: Laguna Beach, CA | Registered:
Mar 2002 |
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