Pet scan before chemo?? : Hi all My mum... - The Roy Castle Lu...

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Pet scan before chemo??

MissyD1 profile image
6 Replies

Hi all

My mum is due to start chemotherapy next week for lung Adenocarcinoma which was initially thought to be early stage but after surgery was deemed a bit more advanced due to microscopic cells being found in the visceral pleura and lymph nodes. We saw the oncologist 2 days ago to discuss chemotherapy, he did say that everything had been removed during the surgery and the 2 ct scans my mum has had since surgery have been clear. However this morning she has had a phone call from the hospital to arrange a pet scan before her next oncology appointment which is next Monday. The secretary only said that the oncologist has requested this but didn't know anything else... this has caused a tremendous amount of anxiety as we had no indication at the appointment that he would be doing this and are now assuming the worst. Has anyone else been in a similar situation and had a pet scan before starting chemo? Any info would be greatly appreciated. Thank you x

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RoyCastleHelpline profile image
RoyCastleHelplinePartnerAsk the NurseRoy Castle

Hi MissyD1,

It is understandable that you are anxious about the unexpected phone call regarding the PET scan. However,there have been studies where PET scans have been carried out before chemotherapy in patients with NSCLC who received standard chemotherapy and then another PET scan repeated during or following a few treatment cycles. The researchers were looking to see if there was a response to treatment by taking a measurement of how metabolically active the tumor was in taking up radiolabeled sugar molecules before and after chemotherapy. This can help to monitor the effect of treatment and determine if the treatment is helpful or futile. This may be the reason the oncologist requested the PET scan before your mum's chemotherapy treatment.Perhaps you should contact the lung cancer nurse specialist involved in your mums care(if you don't know her/his phone number the oncologists secretary will be able to give it to you).

Kind regards,

All the team at the Roy Castle Helpline.

MissyD1 profile image
MissyD1 in reply toRoyCastleHelpline

Thank you for your reply. I phoned the hospital and spoke to a CNS. He explained that following my mums appointment on Monday the oncologist reviewed one of her recent ct scans and noticed a spot on one of her ribs which he would like to investigate further. He explained that it could be inflammation and damage from a large chest drain my mum had inserted to treat pneumothorax or it could be a metastasis... we will find out more on Monday...

RoyCastleHelpline profile image
RoyCastleHelplinePartnerAsk the NurseRoy Castle in reply toMissyD1

Hi MissyD,

I am so pleased that you have managed to speak to the CNS who is a good source of support. Don't hesitate to contact the nurse led Helpline if we can be of any assistance : Free phone 80 358 7200.

Kind regards,

All the team at the Roy Castle Helpline

JanetteR57 profile image
JanetteR57

I initially had a CT scan a month after a 'lesion' on my left lung was found on chest x-ray at emergency presentation at hospital. When I was shown the results of this some time later and was told this 'mass shouldn't be there', and is 'cancer of the lung' but when I asked how/why, this was retracted into 'I don't know, I can't interpret the scan'. When asked what the next course of action was, I was told 'your case will be discussed by the MDT in a couple of days time' to which my next question was 'and then what?' you might be sent for radiotherapy, or a different type of scan or something else, we'll be in touch'. The hospital didn't get in touch but another major hospital in the area rang immediately after the MDT meeting on Thursday afternoon to tell me I was wanted for a PET scan first thing the next morning. Like you, I was scared as google only showed me this was a scan looking for cancer which didn't help my anxiety. However the PET centre were great - really welcoming, clearly explained everything and put me at ease. When the results came in, I had a call from a surgeon's secretary pulling forward my appointment received by post for the following week due to the PET scan results to first thing the next morning. PET (often combined with CT) enables clinicians to see much more detail as the images 'slice the body parts in CT but the PET lights up certain areas differently, giving different and sometimes more accurate information about what is going on in our body. Try not to get anxious each time something else is suggested if you can help it as this anxiety/concern/worry is likely transferred to your mum which won't help.

There are many investigative tools at the disposal of clinicians and several of them take time to assess the results - not everything in our lives can be instant - but these different ways of assessing and monitoring each patient as an individual are crucial not only to ensure the appropriate treatment for the patient but also to rule out some treatments that could potentially be harmful.

My only treatment (and many others) post surgery is a 'watch and wait' scenario so scans (and different types of imaging) become our 'norm' follow up so try not to draw any conclusions just from being processed through the different types in the diagnostic system, just be reassured that if they're using all the tools at their disposal in your mum's care, they're ensuring they have a really good understanding of what's best for her (rather than generic answers you'll be reading if using 'Dr Google' as your information source. good luck.

seasidebob profile image
seasidebob

Hi MissyD1. I know it's easy to say but don't be anxious and don't assume the worst. PET scans are very good because they give information not available in a regular CT. PET scans are a combination of CT and a radioactive sugar scan which shows up any cells in the body which are metabolising at a faster rate than they should be - typical of cancer cells. This allows the radiologists to determine whether something that shows up on a CT is active and therefore needs specific treatment or whether it is something non-malign which can be left or dealt with later. Back last December I was diagnosed with NSCLC but the PET scan picked up a bowel lesion as well which we were all completely unaware of! In the end I had the bowel operation first then another PET before my lobectomy to make sure there were no metastatic growths.

In my case, the post-operative pathological examination of the tumour and lymph nodes removed - the only one that really matters - revealed some spread into the hilar node and because of this and the size of the tumour I was offered adjuvent chemotherapy which I am half-way through. This is standard practice as a PET scan can detect over-active cell clusters in the body down to about the size of a pea but if there is evidence of spread that means there can be 'seedlings' in circulation in the blood or lymph systems which will be undetected. The advantage of the chemo is that it is designed to kill all these cells.

The standard follow-up after chemo is regular scans of one form or another so don't get worried about diagnostic procedures as the more your mum has, the more likely she is to be getting the right targeted treatment in the most timely way.

Good luck and all the best

MissyD1 profile image
MissyD1 in reply toseasidebob

Thank you for the re-assurance seasidebob! Hope you are recovering well from your surgeries and the chemotherapy has been manageable for you.

Sending you all the best!

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