5 questions

I live in a non-english speaking country so language is a problem and most of the time, drs just skim over results in broken English. Need help interpreting my CT scan done with a 3mm slice thickness (?) "Known case of CA ovary, 50 yrs, S/P TAH, BSO,partial omentectomy Oct 2006 . OC stage 4, pleural in right lung/ascites in abdomen/6 cycles of taxol/carbo.
"Findings CHEST: reveals multiple tiny subpleural nodules in both lungs.The largest is 0.5cm. No active pulmonary infiltration as well as no pericardial or pleural effusion is seen.  A few small lymph nordes are noted at the prevascular and precarinal regions.  They are subcentimeter in short axis diameters which are nonspecific.  A few smal bilateral thyroid nodules are seen more on the right".
1. What does this mean??
ABDOMEN: a small ill-defined rapid nobular rim enhancement with persistent contrast staining in delayed phase at hepatic segment V is likely to be hepatic hemangioman, measured about 1.4x1.5x1.0 cm in AP, transverse and vertical diameters, respectively.  Innumerable tiny hypodense lesion are seen scattering in both hepatic lobes, whcih are too small to characterize and probably hepatic cysts.  The portal vein is patent.  The IHD and CBD are not dilated.No ascites or significant lymphadenopathy is observed. Prominent left sided of vaginal stump with a few tiny hyperdense spots are noted."
2. What does this mean?
Also I am concerned about the long gap between cycles, the last one was on the 19th of March and the next one will be on the 27th of April.
3. What is your opinion on this?
4. What is the procedure & frequency is regarding scans in my case: would you have some kinda of a scan done prior to starting chemo?
5.Last is what are the possibilities of OC spreading to breast, especially if already on lungs?
Tks so very much, have been trying for days to post all these questions. Kimchi

[Annekathryn Goodman, M.D.]

Dear Kimchi

Your scan sounds fine. What is being described are the normal lumps and bumps that are seen on the inside just as we all have them on the outside. It is common to have tiny lymph nodes, tiny lung nodules, cysts in the liver and so forth. However your report is reassuring and does not report anything suspicious for recurrence.

In terms of the thyroid nodules, I usually suggest getting a thyroid ultrasound which is the best next test to evaluate your thyroid.

The vaginal stump I guess is what we would call the vaginal cuff which is the top of the vaginal that is stitched together and closed like a mitten after the uterus is removed. I would recommend a pelvic examination to be sure that there are no palpable swellings, cysts, growths int he vagina.

What is important is to make sure that all these findings stay the same. I usually repeat scans every three months to make sure that I am not missing something that is growing.

In general, we like to give chemo every three weeks. 5 weeks seems a bit long.

It would be rare for ovarian cancer to spread to the breasts. It can happen if there is progressive cancer that has returned.
it must be very frustrating to have trouble taking to your doctor. I have found that many doctors in other countries will understand the written English word even if they have trouble speaking and understanding. You could try to write down your questions before your visits and  hand them to your doctor.

take care