My mother-in-law was diagnosed with stage IV adenocarcinoma with mestastases to the adrenal glands and liver today. Her pulmonologist didn't give any type of prognosis - he only recommended treatment (chemo and radiation) and doctors to perform the treatment, and assured her that the chemo & radiation would "help".
I have a copy of the PET scan, and will post it below. Can anyone give me an idea of what her prognosis might be with and without chemo and radiation therapy?
Procedure: PET whole body
Indication: Left Lung Mass
Findings: There is a left hilar mass with abnormal activity identified in multiple locations above and below the diaphragm. A dominant left hilar mass has an SUV measurement of approxiamately 12-15 SUV.
There is dense hypermetabolism in the left lobe of the liver anteriorly with an SUV measurement of 17.5. There is bilateral adrenal abnormality wth masses. The left measures 4.2 SUV and the right, 4.7.
There are multiple foci of abnormal tracer activity in the mediastinum, neck base and left neck. There are several additional sites of hypermetabolism in the liver involving the left lobe and also the posterior right lobe. The appearace is that of rather extensive metastatic disease.
There is a focus in the right iliac bone measuring nearly 4 SUV. Ther is a retroperitoneal focus measuring 4.25 SUV on the right.
Impression: Whole body PET CT fusion study demonstrates an apparent priamary mass in the left hilum with dense hypermetabolism. Multiple metatases above and below the diaphragm with liver metastaes and bilateral adrenal masses and metastases.
That is the end of the report. However, her main symptom is back pain, which the pulmonologist said was probably from mets to the bone. Also, about a week ago, a lump appeared on the top of her head. The pulmonologist thought that this was most likely a tumor as well, and gave her an order for a CT of the brain.
I know all of this is very, very bad news, and am wondering how helpful chemo/radiation can be. Any interpretation or prognosis would be welcomed and appreciated.
First off, make sure that there is a pathologic diagnosis of the cancer. This is obtained by aspiration from a needle or from samples in her phlegm/sputum or obtained through a scope inserted into the lung. If you have this report then this proves the diagnosis.
Your mother-in-law will fall into stage IV disease. Patients in this category have about a 20% chance of survival at 1 year. If she undergoes treatment, it could increase her chances to about 30%. Bear in mind that these are estimates obtained from the experience of others, which does not always hold for all patients. Take note also that not everyone though is a candidate for treatment, this you should discuss with the oncologist/cancer doctor.
You should also consider looking to comfort and quality of life as a goal. While it is hard to target adding years into her life, its important to adding more “life” into what is remaining. There may come a time that pain is too unbearable and pain medications are keeping her drowsy all day, that a different treatment could be sought.
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