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Stage IV colon cancer patient new pet scan results

My husband is a month from being 70 years old, a white male diagnosed with stage iv colon cancer two years ago and had a liver resection. A recent pet scan showed this information.

1. Where is this located?
2. And what research should I be looking for through publications. (I'm very good at this).
3. And lastly are there specific questions I should have for his doctor.

There are nodes in the mediastinum, which are mildly enlarged and
metabolically active.  right paratracheal node mesures 1.4 cm in
greatest AP dimensions, with a maximum SUV of 5. A node in the
anterior mediastinum, located anterior to the SVC measures up to 2 cm
in size and has a maximum SUV of 4.4.

In the left hilum,  mildly increased metabolic activity, with
a maximum SUV of 3.2. No enlarged nodes identified in left hilum.
However, a small focal density which appears parenchymal, in
the prihilar left lung which measures up to 1.3 cm in sie. In
addition, there is a pleural-based nodule in the right middle to late
anteriorily,measures 7 mm in size. A rounded
density in right lower lobe, posterior to the lower lobe pulmonary
artery, could also be parenchymal, measures 1.6 cm in size. This
density and the nodule of the right middle lobe are not metabolically


1. Mildly enlarge metabolically active nodes in the mediastinus, with
maximum SUV of 5.  worrisome for malignant adenopathy.
2. Bilateral parenchymal nodles, not optmally evaluated on this
unenhanced study. Recommend dedicated chest CT with IV contrast for
further evaluation.

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233190 tn?1278553401
I am not an oncologist, so my input into these questions is limited.  

The mediastinum comprises of a group of organs in the chest and is surrounded by connective tissue.

The PET scan suggests active lymph nodes, that may be suggestive of the return of cancer.  

I would suggest reading the patient information site at UptoDate for specific chemotherapy regiments for stage 4 colon cancer:

The question of whether addition of Avastin to the regimen should be discussed with your oncologist, or whether chemotherapy needs to resume based on the PET scan findings.

I would also pursue the chest CT as recommended by the radiologist in the PET scan report.  

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin Pho, M.D.
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