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Hi, I Would Like For You To Reviews Both Cat
Question: Hi, I would like for you to reviews both cat scans. One is on 3/29/2019, and the other one is on 6/10/2019 (73 days later) The impression is written as the following, please read first the cat scan dated 3/29/2019 first. (New Heterogeneous soft tissue density In the region of the pancreas tail resection which is abutting the Kidney measuring 2.6 cm x 2.3 x 2.2cm. Recurrence disease or localized pancreatic is considered. . (first cat scan)
The Oncologist told my Uncle, not sure if it is SCAR TISSUE, but most likely is. No other test were given. In your expertise's, shouldn't the Oncologist Surgeon given in a pet scan to see exactly what the 2.6 cm was. New Heterogeneous soft tissue density In the region of the pancreas tail resection which is abutting the Kidney measuring 2.6 x 2.3 x 2.2 cm
He told him to come back 3 month later to evaluate. The Oncologist was not concerned about this 2.6 x 2.3 by 2.3 cm in on tail of pancreas. As you see by the 73th day after the 2nd cat scan was taken, the results were extremely bad, Increases size to the neurotic mass in the region of pancreatic tail is inseparable from and likely involving the adjacent stomach, anterior kidney, adrenal gland, and splenic flexure measuring 5.4 x 3.6 in size. Metastasized to liver, (2 tumor in liver) one was 8mm, and the other one was 9mm. . Also, retroperitoneal adenopathy which is suspicious for metastatic disease best seen in the aortocaval space measuring 9m on short axis. .
Question 1
If the Oncologist surgeon carefully reviewed the cat scan on 3/29/2019 and did a pet scan to rule out what the 2.6 x 2.3 x2.6cm was. (Scar Tissue or tumor). If it came back as a cancerous tumor on tail of pancreas tail. wouldn't Oncologist Surgeon tell the Oncologist to start chemotherapy right away.to try to shrink that tumor from getting bigger..
Question 2
Couldn't the chemotherapy give him a much better chance of survival to shrink the 2.6 X 2.3 X2.2 soft tissue tumor, and also, the likelihood of it not metastasizing to the liver, and the other area retroperitoneal adenopathy which is suspicious for metastatic disease best seen in the aortocaval space measuring 9m on short axis, and also the lung if it was cancer (Was never identified what the nodule was. (Only bad thing about the nodule in the lung it grew from 4mm to 6mm according to the cat scan)
As a expert in your field, if this was your patients wouldn't you evaluate it, if it was scar tissue or tumor very carefully from the cat scan results on March 29, 2019, came back with a 2.6 x 2.3 x 2.2 cm on tail of pancreas.
WHAT COURSE OF TRATMENT WOULD YOU HAVE STARTED.
My observation is if treatment was started immediately or soon after, his survival rate would of went up a considerable amount. Please give you assessment an expert. I want to thank you very much.
The Oncologist told my Uncle, not sure if it is SCAR TISSUE, but most likely is. No other test were given. In your expertise's, shouldn't the Oncologist Surgeon given in a pet scan to see exactly what the 2.6 cm was. New Heterogeneous soft tissue density In the region of the pancreas tail resection which is abutting the Kidney measuring 2.6 x 2.3 x 2.2 cm
He told him to come back 3 month later to evaluate. The Oncologist was not concerned about this 2.6 x 2.3 by 2.3 cm in on tail of pancreas. As you see by the 73th day after the 2nd cat scan was taken, the results were extremely bad, Increases size to the neurotic mass in the region of pancreatic tail is inseparable from and likely involving the adjacent stomach, anterior kidney, adrenal gland, and splenic flexure measuring 5.4 x 3.6 in size. Metastasized to liver, (2 tumor in liver) one was 8mm, and the other one was 9mm. . Also, retroperitoneal adenopathy which is suspicious for metastatic disease best seen in the aortocaval space measuring 9m on short axis. .
Question 1
If the Oncologist surgeon carefully reviewed the cat scan on 3/29/2019 and did a pet scan to rule out what the 2.6 x 2.3 x2.6cm was. (Scar Tissue or tumor). If it came back as a cancerous tumor on tail of pancreas tail. wouldn't Oncologist Surgeon tell the Oncologist to start chemotherapy right away.to try to shrink that tumor from getting bigger..
Question 2
Couldn't the chemotherapy give him a much better chance of survival to shrink the 2.6 X 2.3 X2.2 soft tissue tumor, and also, the likelihood of it not metastasizing to the liver, and the other area retroperitoneal adenopathy which is suspicious for metastatic disease best seen in the aortocaval space measuring 9m on short axis, and also the lung if it was cancer (Was never identified what the nodule was. (Only bad thing about the nodule in the lung it grew from 4mm to 6mm according to the cat scan)
As a expert in your field, if this was your patients wouldn't you evaluate it, if it was scar tissue or tumor very carefully from the cat scan results on March 29, 2019, came back with a 2.6 x 2.3 x 2.2 cm on tail of pancreas.
WHAT COURSE OF TRATMENT WOULD YOU HAVE STARTED.
My observation is if treatment was started immediately or soon after, his survival rate would of went up a considerable amount. Please give you assessment an expert. I want to thank you very much.
Hi, I would like for you to reviews both cat scans. One is on 3/29/2019, and the other one is on 6/10/2019 (73 days later) The impression is written as the following, please read first the cat scan dated 3/29/2019 first. (New Heterogeneous soft tissue density In the region of the pancreas tail resection which is abutting the Kidney measuring 2.6 cm x 2.3 x 2.2cm. Recurrence disease or localized pancreatic is considered. . (first cat scan)
The Oncologist told my Uncle, not sure if it is SCAR TISSUE, but most likely is. No other test were given. In your expertise's, shouldn't the Oncologist Surgeon given in a pet scan to see exactly what the 2.6 cm was. New Heterogeneous soft tissue density In the region of the pancreas tail resection which is abutting the Kidney measuring 2.6 x 2.3 x 2.2 cm
He told him to come back 3 month later to evaluate. The Oncologist was not concerned about this 2.6 x 2.3 by 2.3 cm in on tail of pancreas. As you see by the 73th day after the 2nd cat scan was taken, the results were extremely bad, Increases size to the neurotic mass in the region of pancreatic tail is inseparable from and likely involving the adjacent stomach, anterior kidney, adrenal gland, and splenic flexure measuring 5.4 x 3.6 in size. Metastasized to liver, (2 tumor in liver) one was 8mm, and the other one was 9mm. . Also, retroperitoneal adenopathy which is suspicious for metastatic disease best seen in the aortocaval space measuring 9m on short axis. .
Question 1
If the Oncologist surgeon carefully reviewed the cat scan on 3/29/2019 and did a pet scan to rule out what the 2.6 x 2.3 x2.6cm was. (Scar Tissue or tumor). If it came back as a cancerous tumor on tail of pancreas tail. wouldn't Oncologist Surgeon tell the Oncologist to start chemotherapy right away.to try to shrink that tumor from getting bigger..
Question 2
Couldn't the chemotherapy give him a much better chance of survival to shrink the 2.6 X 2.3 X2.2 soft tissue tumor, and also, the likelihood of it not metastasizing to the liver, and the other area retroperitoneal adenopathy which is suspicious for metastatic disease best seen in the aortocaval space measuring 9m on short axis, and also the lung if it was cancer (Was never identified what the nodule was. (Only bad thing about the nodule in the lung it grew from 4mm to 6mm according to the cat scan)
As a expert in your field, if this was your patients wouldn't you evaluate it, if it was scar tissue or tumor very carefully from the cat scan results on March 29, 2019, came back with a 2.6 x 2.3 x 2.2 cm on tail of pancreas.
WHAT COURSE OF TRATMENT WOULD YOU HAVE STARTED.
My observation is if treatment was started immediately or soon after, his survival rate would of went up a considerable amount. Please give you assessment an expert. I want to thank you very much.
The Oncologist told my Uncle, not sure if it is SCAR TISSUE, but most likely is. No other test were given. In your expertise's, shouldn't the Oncologist Surgeon given in a pet scan to see exactly what the 2.6 cm was. New Heterogeneous soft tissue density In the region of the pancreas tail resection which is abutting the Kidney measuring 2.6 x 2.3 x 2.2 cm
He told him to come back 3 month later to evaluate. The Oncologist was not concerned about this 2.6 x 2.3 by 2.3 cm in on tail of pancreas. As you see by the 73th day after the 2nd cat scan was taken, the results were extremely bad, Increases size to the neurotic mass in the region of pancreatic tail is inseparable from and likely involving the adjacent stomach, anterior kidney, adrenal gland, and splenic flexure measuring 5.4 x 3.6 in size. Metastasized to liver, (2 tumor in liver) one was 8mm, and the other one was 9mm. . Also, retroperitoneal adenopathy which is suspicious for metastatic disease best seen in the aortocaval space measuring 9m on short axis. .
Question 1
If the Oncologist surgeon carefully reviewed the cat scan on 3/29/2019 and did a pet scan to rule out what the 2.6 x 2.3 x2.6cm was. (Scar Tissue or tumor). If it came back as a cancerous tumor on tail of pancreas tail. wouldn't Oncologist Surgeon tell the Oncologist to start chemotherapy right away.to try to shrink that tumor from getting bigger..
Question 2
Couldn't the chemotherapy give him a much better chance of survival to shrink the 2.6 X 2.3 X2.2 soft tissue tumor, and also, the likelihood of it not metastasizing to the liver, and the other area retroperitoneal adenopathy which is suspicious for metastatic disease best seen in the aortocaval space measuring 9m on short axis, and also the lung if it was cancer (Was never identified what the nodule was. (Only bad thing about the nodule in the lung it grew from 4mm to 6mm according to the cat scan)
As a expert in your field, if this was your patients wouldn't you evaluate it, if it was scar tissue or tumor very carefully from the cat scan results on March 29, 2019, came back with a 2.6 x 2.3 x 2.2 cm on tail of pancreas.
WHAT COURSE OF TRATMENT WOULD YOU HAVE STARTED.
My observation is if treatment was started immediately or soon after, his survival rate would of went up a considerable amount. Please give you assessment an expert. I want to thank you very much.
Brief Answer:
Very difficult to comment retrospectively
Detailed Answer:
Thanks for your query.
I understand your concerns. I've checked the CT reports.
Unfortunately, the disease has progressed and metastasized. However, I must admit that in clinical medicine we always get wiser on retrospect but while deciding on present evidence, many a time we do not know the correct course of action. Of course, in that scenario, a PET CT could have been ordered and if that picked up recurrence we could have started chemotherapy. But at that point, his doctor thought otherwise.
Now, whether starting chemo earlier would guarantee an improved prognosis is highly debatable. This is a recurrent disease we are dealing with and the rule of thumb is that palliative chemotherapy is not curative and as long as the patient has not deteriorated to such an extent that he is not in a position to take chemotherapy any more, the survival is not shortened, at least not significantly.
So, to summarize, I would have probably ordered PET CT in March and started chemotherapy at that time, but please don't forget that I am being heavily influenced by this present CT scan which would not have been available to me at that time.
Hope this helps.
Regards
Very difficult to comment retrospectively
Detailed Answer:
Thanks for your query.
I understand your concerns. I've checked the CT reports.
Unfortunately, the disease has progressed and metastasized. However, I must admit that in clinical medicine we always get wiser on retrospect but while deciding on present evidence, many a time we do not know the correct course of action. Of course, in that scenario, a PET CT could have been ordered and if that picked up recurrence we could have started chemotherapy. But at that point, his doctor thought otherwise.
Now, whether starting chemo earlier would guarantee an improved prognosis is highly debatable. This is a recurrent disease we are dealing with and the rule of thumb is that palliative chemotherapy is not curative and as long as the patient has not deteriorated to such an extent that he is not in a position to take chemotherapy any more, the survival is not shortened, at least not significantly.
So, to summarize, I would have probably ordered PET CT in March and started chemotherapy at that time, but please don't forget that I am being heavily influenced by this present CT scan which would not have been available to me at that time.
Hope this helps.
Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Brief Answer:
Very difficult to comment retrospectively
Detailed Answer:
Thanks for your query.
I understand your concerns. I've checked the CT reports.
Unfortunately, the disease has progressed and metastasized. However, I must admit that in clinical medicine we always get wiser on retrospect but while deciding on present evidence, many a time we do not know the correct course of action. Of course, in that scenario, a PET CT could have been ordered and if that picked up recurrence we could have started chemotherapy. But at that point, his doctor thought otherwise.
Now, whether starting chemo earlier would guarantee an improved prognosis is highly debatable. This is a recurrent disease we are dealing with and the rule of thumb is that palliative chemotherapy is not curative and as long as the patient has not deteriorated to such an extent that he is not in a position to take chemotherapy any more, the survival is not shortened, at least not significantly.
So, to summarize, I would have probably ordered PET CT in March and started chemotherapy at that time, but please don't forget that I am being heavily influenced by this present CT scan which would not have been available to me at that time.
Hope this helps.
Regards
Very difficult to comment retrospectively
Detailed Answer:
Thanks for your query.
I understand your concerns. I've checked the CT reports.
Unfortunately, the disease has progressed and metastasized. However, I must admit that in clinical medicine we always get wiser on retrospect but while deciding on present evidence, many a time we do not know the correct course of action. Of course, in that scenario, a PET CT could have been ordered and if that picked up recurrence we could have started chemotherapy. But at that point, his doctor thought otherwise.
Now, whether starting chemo earlier would guarantee an improved prognosis is highly debatable. This is a recurrent disease we are dealing with and the rule of thumb is that palliative chemotherapy is not curative and as long as the patient has not deteriorated to such an extent that he is not in a position to take chemotherapy any more, the survival is not shortened, at least not significantly.
So, to summarize, I would have probably ordered PET CT in March and started chemotherapy at that time, but please don't forget that I am being heavily influenced by this present CT scan which would not have been available to me at that time.
Hope this helps.
Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Hi, thank you.
Could you please comment on this. Would he have had a better chance if the chemo was started as they determined when it was a tumor size of of 2.6 x 2.3 x 2.3. on March 29, 2019 instead of the increase tumor size of 5.6 x 2.3 cm.
Meaning if they gave him the chemotherapy then, then it would have a much small chance spreading to the liver, and other area. Yes or No
Also isn't it easier to shrink a t 2.6 x 2.3 x 2.2 cm tumor than a larger one which was 5.6 x 3.6 cm. Yes or No
Last, look what happened in 73 days later, it spread to 2 tumors in liver, and also maybe one in lung, and also in the retroperitoneal adenopathy area.
Please answerer these questions, Thank you.
Could you please comment on this. Would he have had a better chance if the chemo was started as they determined when it was a tumor size of of 2.6 x 2.3 x 2.3. on March 29, 2019 instead of the increase tumor size of 5.6 x 2.3 cm.
Meaning if they gave him the chemotherapy then, then it would have a much small chance spreading to the liver, and other area. Yes or No
Also isn't it easier to shrink a t 2.6 x 2.3 x 2.2 cm tumor than a larger one which was 5.6 x 3.6 cm. Yes or No
Last, look what happened in 73 days later, it spread to 2 tumors in liver, and also maybe one in lung, and also in the retroperitoneal adenopathy area.
Please answerer these questions, Thank you.
Hi, thank you.
Could you please comment on this. Would he have had a better chance if the chemo was started as they determined when it was a tumor size of of 2.6 x 2.3 x 2.3. on March 29, 2019 instead of the increase tumor size of 5.6 x 2.3 cm.
Meaning if they gave him the chemotherapy then, then it would have a much small chance spreading to the liver, and other area. Yes or No
Also isn't it easier to shrink a t 2.6 x 2.3 x 2.2 cm tumor than a larger one which was 5.6 x 3.6 cm. Yes or No
Last, look what happened in 73 days later, it spread to 2 tumors in liver, and also maybe one in lung, and also in the retroperitoneal adenopathy area.
Please answerer these questions, Thank you.
Could you please comment on this. Would he have had a better chance if the chemo was started as they determined when it was a tumor size of of 2.6 x 2.3 x 2.3. on March 29, 2019 instead of the increase tumor size of 5.6 x 2.3 cm.
Meaning if they gave him the chemotherapy then, then it would have a much small chance spreading to the liver, and other area. Yes or No
Also isn't it easier to shrink a t 2.6 x 2.3 x 2.2 cm tumor than a larger one which was 5.6 x 3.6 cm. Yes or No
Last, look what happened in 73 days later, it spread to 2 tumors in liver, and also maybe one in lung, and also in the retroperitoneal adenopathy area.
Please answerer these questions, Thank you.
Brief Answer:
Please find answers to your specific questions below
Detailed Answer:
1.yes
2. Yes
3. No question is given. But yes, I agree that it has spread a lot.
Regards
Please find answers to your specific questions below
Detailed Answer:
1.yes
2. Yes
3. No question is given. But yes, I agree that it has spread a lot.
Regards
Above answer was peer-reviewed by :
Dr. Kampana
Brief Answer:
Please find answers to your specific questions below
Detailed Answer:
1.yes
2. Yes
3. No question is given. But yes, I agree that it has spread a lot.
Regards
Please find answers to your specific questions below
Detailed Answer:
1.yes
2. Yes
3. No question is given. But yes, I agree that it has spread a lot.
Regards
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Kampana
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