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I am interested in your opinion...
Hi Doctor, I am female. I have never smoked in my life. My December 2007 CT scan is as follows. CT chest, abdomen and pelvis. Left neck mass. Technique: IV contrast. Comparison: Previous CT of the abdomen and pelvis October 2007. CT Chest: A portion of the lower chest was included on the previous CT of October 2007. There has been interval progression of bilateral anterior epiphrenic lymphadenopathy, with increase in the number of epiphrenic nodes on the right and enlargement bilaterally. The largest confluent node on the right now measures 2.4 x 2.2 cm (axial image 94) compared to previous measurements of 1.6 x 1.4 cm. There is now right internal mammary chain lymphadenopathy with a 1.8 cm internal mammary chain node identified on axial image 65. Mild right anterior mediastinal lymphadenopathy is present and there is lymphadenopathy in the left superior mediastinum along the lateral aspect of the arch of the aorta and the aortopulmonary window extending along the lateral aspect of the left hilum. No pulmonary lesions are identified. There is no evidence of pleural fluid. No body abnormality is identified. Enlargement and inhomogeneity of the thyroid, particularly the left lobe was present on a previous PE CT of May 2, 2006 and most likely represents a goiter.
CT Abdomen & Pelvis: Progression of bilateral epiphrenic lymphadenopathy is again identified. The liver and spleen are within normal limits with two small stable focal low attenuation hepatic lesions most compatible with cysts. No para-aortic or pelvic lymphadenopathy is identified. There is no evidence of ascites. Scarring of the mid right kidney and to a lesser degree the lower pole of the right kidney is stable. The left kidney is unremarkable. There is no evidence of hydronephrosis and no bone lesion is identified.
Impression: Bilateral epiphrenic lymphadenopathy which has increased since October 2007. Right internal mammary chain and right anterior mediastinal and left superior mediastinal lymphadenopathy. A pulmonary embolism CT of May 2006 demonstrated the left superior mediastinal lymphadenopathy and the right anterior mediastinal lymphadenopathy may also have been present at that time, but the internal mammary chain lymphadenopathy has developed over the interval.
Doctor, from your experience, with chemo and without chemo, what kind of survival times do you think I have? Please be candid. I am thick skinned. Thank you!
CT Abdomen & Pelvis: Progression of bilateral epiphrenic lymphadenopathy is again identified. The liver and spleen are within normal limits with two small stable focal low attenuation hepatic lesions most compatible with cysts. No para-aortic or pelvic lymphadenopathy is identified. There is no evidence of ascites. Scarring of the mid right kidney and to a lesser degree the lower pole of the right kidney is stable. The left kidney is unremarkable. There is no evidence of hydronephrosis and no bone lesion is identified.
Impression: Bilateral epiphrenic lymphadenopathy which has increased since October 2007. Right internal mammary chain and right anterior mediastinal and left superior mediastinal lymphadenopathy. A pulmonary embolism CT of May 2006 demonstrated the left superior mediastinal lymphadenopathy and the right anterior mediastinal lymphadenopathy may also have been present at that time, but the internal mammary chain lymphadenopathy has developed over the interval.
Doctor, from your experience, with chemo and without chemo, what kind of survival times do you think I have? Please be candid. I am thick skinned. Thank you!
Hi,
The link you gave cleared up a lot of matters.
The lymph nodes that are seen in your scans are not likely due to Hodgkin's Disease which is a different kind of cancer. It is more likely that they represent disease from the original ovarian cancer.
Survival times in general for disseminated disease would be around 10% surviving at 5 years.
Treatment targeting survival may only yield modest gains, but there are other considerations like quality of life which is also very important.
Best you discuss matters with your doctor.
The link you gave cleared up a lot of matters.
The lymph nodes that are seen in your scans are not likely due to Hodgkin's Disease which is a different kind of cancer. It is more likely that they represent disease from the original ovarian cancer.
Survival times in general for disseminated disease would be around 10% surviving at 5 years.
Treatment targeting survival may only yield modest gains, but there are other considerations like quality of life which is also very important.
Best you discuss matters with your doctor.
Hi Doctor, I think you will get a better picture of my medical history if you look at this website http://es.medhelp.org/posts/show/286533. The doctor's recent report says that I have multi-site intrathoracic adenopathy which explains the difficulty I have breathing and that he recommends the institution of chemo treatment. Tumor marker as of this week is 170. I have never undergone bronchoscopy treatment. Doctor, do I have Hodgkin's disease? Thanks.
Hi,
Tumor markers do not replace the information that can be obtained by a biopsy. I would still maintain the suggestion of getting the biopsy.
The only scenario that tumor markers are used to make a diagnosis is in the scenario of a young man, with a mass in the mediastinum that is too difficult to biopsy. This specific population is well-studied and hence, the toxicities of chemotherapy are risked based on sound evidence.
Do you know what the tumor markers were? I'm wondering also if you underwent a bronchoscopy (a small tube with a camera inserted into the lung from the nose) and if they obtained malignant cells through the tube. The word biopsy may not be used - but cytology. If such is the case - then I wouldn't insist on the biopsy.
Tumor markers do not replace the information that can be obtained by a biopsy. I would still maintain the suggestion of getting the biopsy.
The only scenario that tumor markers are used to make a diagnosis is in the scenario of a young man, with a mass in the mediastinum that is too difficult to biopsy. This specific population is well-studied and hence, the toxicities of chemotherapy are risked based on sound evidence.
Do you know what the tumor markers were? I'm wondering also if you underwent a bronchoscopy (a small tube with a camera inserted into the lung from the nose) and if they obtained malignant cells through the tube. The word biopsy may not be used - but cytology. If such is the case - then I wouldn't insist on the biopsy.
Hi Doctor, Thank you for your comments. I am assuming the nodes are malignant because it's raising the tumor markers by three-fold. My oncologist declined my request to remove the mass. He says option is to take chemo because there are too many nodules involved. I am 51 years old and fairly healthy.
Hi,
If the CT scan comprises the entirety of your work-up, then it would be premature to discuss survival.
The first step in answering your question is to find out if the nodes represent malignancy or not. And what kind of malignancy if it is a malignancy. Not all malignancies are terminal, there are malignancies that can be cured. A diagnosis will require sampling (biopsy) of the nodes. Looking at you description, perhaps the most accessible site is the neck mass.
There are biopsies done with small needles, but it may be better to take out more tissue by removing the entire neck mass (if technically feasible) or a portion of it.
Survival is also a question of how old you are and how healthy you are. It would be best to discuss specifics with a doctor who can examine you.
Stay positive.
If the CT scan comprises the entirety of your work-up, then it would be premature to discuss survival.
The first step in answering your question is to find out if the nodes represent malignancy or not. And what kind of malignancy if it is a malignancy. Not all malignancies are terminal, there are malignancies that can be cured. A diagnosis will require sampling (biopsy) of the nodes. Looking at you description, perhaps the most accessible site is the neck mass.
There are biopsies done with small needles, but it may be better to take out more tissue by removing the entire neck mass (if technically feasible) or a portion of it.
Survival is also a question of how old you are and how healthy you are. It would be best to discuss specifics with a doctor who can examine you.
Stay positive.
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