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What Does My CT Scan Report Indicate?
Question: Hi Doctor,
My oncologist said today that looking at my recent cat scan I could be a candidate for resection.However when compared to 6/2017 cat scan 6/2016 scan showed many very small lesions that are not detectable by any test.His concern is after the resection these undetectable lesions may still be cancerous and grow.
I have the best liver surgeon in the US on 4/12 to see me.Do you have the same concerns that my current doctor has.
My thinking is they have disappeared from chemo.If the large tumors are removed and I continue maintaince chemo why would that not keep the microscopic undetectable lesions from reappearing.
Thank you,
XXXXXXX
My oncologist said today that looking at my recent cat scan I could be a candidate for resection.However when compared to 6/2017 cat scan 6/2016 scan showed many very small lesions that are not detectable by any test.His concern is after the resection these undetectable lesions may still be cancerous and grow.
I have the best liver surgeon in the US on 4/12 to see me.Do you have the same concerns that my current doctor has.
My thinking is they have disappeared from chemo.If the large tumors are removed and I continue maintaince chemo why would that not keep the microscopic undetectable lesions from reappearing.
Thank you,
XXXXXXX
Brief Answer:
See next
Detailed Answer:
Hi and thank you for contacting me.
I understand your thoughts but there are few complex issues. Unfortunately,liver tumors respond poorly on chemotherapy and if diffuse small lesions are present then chemotherapy will not be able to kill all these malignant cells,but it will slow down size progression and prolong lifetime. So chemotherapy can't be curable and if any tumor is left after resection,then the disease will progress. There is option for repeated resections if tumor recur after chemotherapy and if sufficient liver tissue can be preserved. But in case of diffuse small lesion,this is not possible and prognosis is poor in this case,but this can be verified only during the surgery. So you should definitely undergo surgery but you should expect long fight more,postoperative chemotherapy and repeated reevaluation of the disease. chemotherapy can also be replaced by different or more aggressive protocols if tumor become resistant.
See next
Detailed Answer:
Hi and thank you for contacting me.
I understand your thoughts but there are few complex issues. Unfortunately,liver tumors respond poorly on chemotherapy and if diffuse small lesions are present then chemotherapy will not be able to kill all these malignant cells,but it will slow down size progression and prolong lifetime. So chemotherapy can't be curable and if any tumor is left after resection,then the disease will progress. There is option for repeated resections if tumor recur after chemotherapy and if sufficient liver tissue can be preserved. But in case of diffuse small lesion,this is not possible and prognosis is poor in this case,but this can be verified only during the surgery. So you should definitely undergo surgery but you should expect long fight more,postoperative chemotherapy and repeated reevaluation of the disease. chemotherapy can also be replaced by different or more aggressive protocols if tumor become resistant.
Above answer was peer-reviewed by :
Dr. Remy Koshy
Hi Doctor,
Chemo has worded extremely well which is why they tell me resection may be possible.Cat scan or MRI can not detect small lesions were there in XXXXXXX so chemo must have killed them.
In this case would lever resection be the right answer?
Thank you
Frred
Chemo has worded extremely well which is why they tell me resection may be possible.Cat scan or MRI can not detect small lesions were there in XXXXXXX so chemo must have killed them.
In this case would lever resection be the right answer?
Thank you
Frred
Brief Answer:
Yes
Detailed Answer:
If MRI didn't detect any new lesions then this is a good sign and liver resection is worth of try since this is the only way to achieve long-term survival. honestly, complete cure should not be expected,but chemotherapy alone will not have significant impact on survival even though it was efficient last time. Also,surgery is the only way to determine the extent of the disease properly and also biopsy can be taken to see more detailed tumor characteristics. If you want,you can send me medical documentation and I'll be able to tell you more about possibilities.
Yes
Detailed Answer:
If MRI didn't detect any new lesions then this is a good sign and liver resection is worth of try since this is the only way to achieve long-term survival. honestly, complete cure should not be expected,but chemotherapy alone will not have significant impact on survival even though it was efficient last time. Also,surgery is the only way to determine the extent of the disease properly and also biopsy can be taken to see more detailed tumor characteristics. If you want,you can send me medical documentation and I'll be able to tell you more about possibilities.
Above answer was peer-reviewed by :
Dr. Kampana
Hi Doctor,
Only cat scans so far.Last 2/4/2016.Doctor said yesterday that based on this scan he thinks liver resectionn may work but is concerned about cat scan last XXXXXXX This is below the 2/4/2016 test results
2/4/2016
LIVER: There are 3 hypoenhancing hepatic lesions in segment VI. A lesion now measuring 3.4 x
4.1 x 4.2 cm is decreased from 8.1 x 9.9 x 8.0 cm. A 3.4 x 2.3 x 3.6 cm mass is seen in close
abutment, decreased from 5.7 x 6.7 x 5.9 cm. An inferolateral
lesion measuring 2.2 x 4.1 x 4.2 cm is also present and has decreased from 5.0 x 7.4 x 7.3 cm.
A tiny hypoattenuating focus in the inferior right hepatic lobe measures 0.6 x 0.7 x 0.9 cm
appears decreased from 1.3 x 1.5 x 1.2 cm.
Additional smaller foci are not well characterized secondary to artifact, but appear
decreased in conspicuity.
5/31/2016 before surgery
LIVER: Enhancing solid masses are seen within the right lobe of the liver most pronounced
inferiorly. Large hepatic lesions measuring up to 10.2 cm on image 200, 7.3 cm on image 216 and 5.9
cm on image. In the left lobe smaller focus is seen in the lateral segment measuring 1.3 cm on image
178 with small focus in the anterior segment of the right lobe measuring 1.1 cm on image 173.
Additional faint focus is suspected in the dome of the left hepatic lobe laterally measuring up to
1.4 cm.
This was taken on 6/21/2016.They could not give me chemo in between
5/31 and 6/21 because of the need for healing that is why tumors grew during this period.
Thank you,
XXXXXXX
Only cat scans so far.Last 2/4/2016.Doctor said yesterday that based on this scan he thinks liver resectionn may work but is concerned about cat scan last XXXXXXX This is below the 2/4/2016 test results
2/4/2016
LIVER: There are 3 hypoenhancing hepatic lesions in segment VI. A lesion now measuring 3.4 x
4.1 x 4.2 cm is decreased from 8.1 x 9.9 x 8.0 cm. A 3.4 x 2.3 x 3.6 cm mass is seen in close
abutment, decreased from 5.7 x 6.7 x 5.9 cm. An inferolateral
lesion measuring 2.2 x 4.1 x 4.2 cm is also present and has decreased from 5.0 x 7.4 x 7.3 cm.
A tiny hypoattenuating focus in the inferior right hepatic lobe measures 0.6 x 0.7 x 0.9 cm
appears decreased from 1.3 x 1.5 x 1.2 cm.
Additional smaller foci are not well characterized secondary to artifact, but appear
decreased in conspicuity.
5/31/2016 before surgery
LIVER: Enhancing solid masses are seen within the right lobe of the liver most pronounced
inferiorly. Large hepatic lesions measuring up to 10.2 cm on image 200, 7.3 cm on image 216 and 5.9
cm on image. In the left lobe smaller focus is seen in the lateral segment measuring 1.3 cm on image
178 with small focus in the anterior segment of the right lobe measuring 1.1 cm on image 173.
Additional faint focus is suspected in the dome of the left hepatic lobe laterally measuring up to
1.4 cm.
This was taken on 6/21/2016.They could not give me chemo in between
5/31 and 6/21 because of the need for healing that is why tumors grew during this period.
Thank you,
XXXXXXX
Hi Doctor,
I received an email saying this question had been answered but nthing here
Thank you,
XXXXXXX
I received an email saying this question had been answered but nthing here
Thank you,
XXXXXXX
Brief Answer:
hi
Detailed Answer:
Hi. YOu dont have to open new queries. Just ask follow up question.
Well, there are large lesions and usually it cant be expected that only right lobe is involved. But CT scan shows that these are limited to the right lobe only,although lesions smaller than 0.5cm cant be seen on CT scan and only surgery can be used to verify if lesions exist in left lobe. If not, then right or extended right hepatectomy can be performed...which would be great for you..
hi
Detailed Answer:
Hi. YOu dont have to open new queries. Just ask follow up question.
Well, there are large lesions and usually it cant be expected that only right lobe is involved. But CT scan shows that these are limited to the right lobe only,although lesions smaller than 0.5cm cant be seen on CT scan and only surgery can be used to verify if lesions exist in left lobe. If not, then right or extended right hepatectomy can be performed...which would be great for you..
Above answer was peer-reviewed by :
Dr. Raju A.T
Hi Doctor,
I went to a naturopathic institute yesterday.They are affiliated with Northwestern Medical.My doctor did her internship at cancer center of XXXXXXX and worked there for three years before joining the Raby institute in XXXXXXX They do not tell you natural medications instead of chemo.They look at the chemo medication you are currently taking and then suggest supplemental as well as a detailed diet.I would like to know if you have any experience with natural medicines.
Here is what they have suggested, reshi spore oil, curcumin, myco-immune (Thorne), Avemar, carnityl (Thorne)
I do not know what an oncologist would say about these but many have been used in Asia for thousands of years.I currently am on the folferi regime.
Thank you,
XXXXXXX
I went to a naturopathic institute yesterday.They are affiliated with Northwestern Medical.My doctor did her internship at cancer center of XXXXXXX and worked there for three years before joining the Raby institute in XXXXXXX They do not tell you natural medications instead of chemo.They look at the chemo medication you are currently taking and then suggest supplemental as well as a detailed diet.I would like to know if you have any experience with natural medicines.
Here is what they have suggested, reshi spore oil, curcumin, myco-immune (Thorne), Avemar, carnityl (Thorne)
I do not know what an oncologist would say about these but many have been used in Asia for thousands of years.I currently am on the folferi regime.
Thank you,
XXXXXXX
Brief Answer:
Hi
Detailed Answer:
I dont have experience with these specific supplements, but I am familiar with importance of nutritional support in oncologic patients. It is important to intake enough vitamins and minerals to improve your immune system which can indirectly affect your general health and strength. This may also help with chemotherapy side effects. However, regarding tumor size or progression, dont expect anything and only chemotherapy and surgery may bring clear benefits. There are many supplements and herbal products which are promoted as beneficial for cancers, but for may of these there is no any scientific support. If these products that you have mentioned are rich in vitamins and other natural nutrients then you can take it, and it wont be harmful at least.
Hi
Detailed Answer:
I dont have experience with these specific supplements, but I am familiar with importance of nutritional support in oncologic patients. It is important to intake enough vitamins and minerals to improve your immune system which can indirectly affect your general health and strength. This may also help with chemotherapy side effects. However, regarding tumor size or progression, dont expect anything and only chemotherapy and surgery may bring clear benefits. There are many supplements and herbal products which are promoted as beneficial for cancers, but for may of these there is no any scientific support. If these products that you have mentioned are rich in vitamins and other natural nutrients then you can take it, and it wont be harmful at least.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
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