Women who don't have BRCA mutations could have other high-risk genes that affect treatment choices
by Rich1951 on Tue Jun 26, 2007 12:00 AM
I recently had a chest X-ray, CT and PET scan. The pet scan revealed a nodule in the right apical region approximately 1.7 cm with a maximum SUV of 6.0. Also found markedly increased metabolic activity in the right paratracheal mediatinum with a maximum SUV of 12.0. Can someone tell me what the difference of a 6.0 vs. 12.0 SUV rating. I spoke with a surgeon yesterday (he removed my middle lobe of same lung 8 years ago - it was a benign tumor) and yes as president of the Morons of America I kept smoking.
He wants to go down my throat and get a biopsy. After he confirms the malignantcy in the lymph he said he would like to "melt" it first with chemo and radiation and then remove whatever is left. Does this sound normal? I always thought chemo and radiation came after surgery. Staging by PET scan was T1.N2. Can someone try to explain in plain English where I stand.
Thank you I appreciate taking the time to try to answer.
by Pbj11 on Tue Jun 26, 2007 12:00 AM
Sounds like he thinks you are still a candidate for a "cure". Often they will use chemo and radiation to shrink the tumors before going in and removing them. I guess it makes things easier to get it all if they can shrink them beforehand.
I just discovered some terminology relating to SUV levels in my husband's most recent PET scan. Seems like a 2 point difference is considered "slight" change from one scan to another. You can take it from there what a 6 point difference means. Also, any SUV rating in a known cancer situation over 2.5 is considered malignant, although other diseases like sarcoid can produce elevated SUV numbers. That's why he's doing the biopsy. The higher the number, the more active the cancer is. We've never been above about 12.9, but I've seen others with higher SUV values. You also may be in for more chemo after the removal to make sure any stray cancer cells are mopped up.
BTW, I'm a member of the same club. :-((
by Witchdoctor on Tue Jun 26, 2007 12:00 AM
The treatment you are being offered is State of the art and if the chemo radiation downstages the tumor it could give a cure rate in the 60 percent range. This is currently investigational but is based on other studies with preop chemo. They found benefit with the chemo in the people who had a complete response in the mediastinum and underwent surgery. Problem was only 28 percent of the people were downstaged. Now they are combining the chemo and radiation because it has been show to downstage up to 70 percent so hopefully the combination will cure more people. If they are not downstaged then treatment is continued as definitive chemo rads.
The SUV number indicate metabolic activity, anything above 3 is suspicious and more so as the number gets higher. There are false positives , but overall it is highly specific. High SUV numbers could indicate a faster growing more aggressive tumor.
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