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Additional Findings on New CT Scan

My sister battled thyroid cancer in 2012 and was diagnosed with Melanoma Stage IIC, which they said was the worse form of melanoma, in May of 2013. She had the wide excision surgery and sentinel node biopsy and they seem to have gotten all of the cancer. However, every time she goes back for her CT scans new nodules are detected. Her latest scan revealed: new nodular opacity with "additional tree-in-bud opacities" in the left lung, 3mm peri-fissure nodule along the right major fissure, a 3mm right lower lobe lung nodule, new nodular "opacity" measuring 1.8 x 1.2 cm at the site of previous "atelectasis", stable 9mm right hilar lymph node, stable left hilar lymphadenopathy with nodes measuring up to 11mm, a few small pretracheal lymph nodes stable, small para-sternal nodular opacity. The abdomen revealed: small gallstones, mild nodular hyperplasia of left adrenal gland, stable appearance of a nodular opacity posterior to the Gerota's fascia on the right side measuring 9mm. The pelvis revealed: small and large bowel loops and a stable appearance of a 1.6 x 1.1cm soft tissue nodule in the right mesorectal fat.

It seems to me something is going on with her cancer. Usually she goes for her bloodwork, scans, then sees her oncologist all in the same day. They always have the results of the scans immediately so her oncologist can review them with us, but this time only her head CT was available. Now three days later she gets the new results via an email notification thru her online medical chart. When she told me of the latest findings, she doesn't seem concerned. Her outlook is: if the doctor isn't worried and calling, then everything's okay. Should we be concerned with the newer findings and try and contact her oncologist? Please help! I am worried for her. She was born with tumors, but it seems her health is just deteriorating. Cancer runs on both sides of our family but her melanoma is a genetic type.
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6644139 tn?1384785657
MEDICAL PROFESSIONAL
Hi there,
Sorry I'm just now getting to this, I didn't see the post before.  Yes I would be concerned personally, anyone with a history of cancer who has "new" nodules on CT imaging would cause me concern.  Has she had any follow up appointments?
Thanks,
John
Helpful - 1
Avatar universal
Actually yes, she just received her latest scan results which showed two addition nodules and a few other things we don't quite understand. We are going for a second opinion. I think the problem is that she has Medicare and instead of doing PET scans, like a few others said she should have, she's been having just CT scans. From what the oncologist explained- she has the worse and most aggressive form of melanoma. It was nodular, Bresthlow Depth exceeded 8mm, it was ulcerated, a "polypoid", high mitotic rate and at least a IV on the Clark Scale (whatever that means). She had it on her foot for well over three years but because it was flesh/skin colored, she believed it was a wart and then over time it grew and became infected so she had it checked. Both her primary doctor and the plastic surgeon who removed it for biopsy didn't believe it to be any skin cancer. They too thought it was an infection of some sort. Now she has had many back surgeries so she has had countless MRIs, X-rays, ct scans and nothing was ever detected on those. Now since the melanoma, all of these nodules are popping up everywhere. And her oncologist wants them to just keep an eye on them. He said that they're small nodules, when they reach a certain size- then he will become more concerned. Even with newer nodules appearing on each scan; as long as the previous nodules haven't grown he just wants to watch and wait. I've talked to a few friends and was told she should have PET scans because they are better able to detect small spreading cancers. I just don't think it's normal for new nodules to appear and nothing be done. So we are taking her for a second opinion and a PET scan. Just like the cancer on her foot (which slowly grew over three years until finally growing fast, that's what could be going on inside her body now. This latest scan picked up many gall stones, bowel loops, free fluid within pelvis, a new 4mm nodule on the anterior right acetabulum, a 3mm nodular thickening along right major fissure, tree in bud nodularity in the lower lobe, there is cholelithiasis, retroperitoneal nodule, additional sclerotic focus within the right inferior pubic ramus, cyst within right ovary and triangular soft tissue in the anterior mediastinum but could likely be residual thymus or thymic hyperplasia. Now to me, all of that is concerning given the type of melanoma she has. I'm not happy with the oncologists lack of precaution. A PET scan would help alleviate some of the concern. He just explains nothing to us at all.  
Helpful - 0

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