Brian data from PET/CT this week....

transcribed 30 Sep 2009

Size SUV max SUV surrounding lung location
0.4 0.33/0.66 0.36 LUL, posteriorly
0.7 0.89/1.47 0.59 RLL, posteriorly
0.8 1.04/1.35 0.64 RUL
0.5 1.35/1.54 0.94 LUL
0.8 0.83/1.08 0.73 RLL, posteriorly

I believe that these are all inflammation level SUV values. 2.5 is interesting, and is the beginning line for things that MIGHT be malignant, and should get someone's attention, 3.5-4.0 and up is a red flag to take a closer look via a biopsy or other sampling technique in most cases. With the utmost respect for Suzanne's comments, this is not an anatomical area that I would want to have a surgical procedure on without serious reasons. I would opt for a CT guided biopsy if the numbers were slightly higher just to be on the safe side and if that came up positive, then I would let the cutters have their way if everyone else on the team was on board with the idea. Please note the disclaimer that I am not an expert nor a doctor, and I only am passing on what 10 years of watching others deal with these things has taught me. Your milage may vary.

I edited the previous posting. I wanted to make it clear that you should not put too much weight on any opinion that I express in a matter that is already so subjective. PET's are notorious for lighting up low level SUV's like these, and many people obviously get worried about them. I routinely have levels higher than this in my lungs because of the infections that take place because of my silent aspiration. None of those have been a malignancy. Remember that a PET scan is only one data point on a long line of decision making opportunities. When you get 3+ data points all pointing towards the same thing, it is definitely time to take action.

I have a needle bioposy on the 8th of a lymph node that was involved prior to treatment and a consult with the thoracic surgeon. RAD/ONC ordered the biopsy to dispel the "cancer has spread" idea. I'll let you know how things go.

Unable to needle biopsy in my neck today. Ultrasound was showing the gland too close to risk going after the tissue.

Had the consult with the Cardio/Thoracic surgeon immediately following. Decided to go with the biopsy in lieu of waiting. His concern and that of the tumor board is the size and shape of the nodule.

Pre-op on Tuesday the 13th, Surgery on the 14th at Bethesda Naval Hospital. I want to rule out metastatic growth sooner than later.

So, the pre-op is for the biopsy? Did I understand that correctly?

I agree, it's always better to know sooner than later. Time is our friend:)

Good luck Bill

The worst has come to fruition. The growth that was removed from my lung is malignant. Now to see if there is a clinical trial that may help me. I guess lung cancer is seen as a smoker's cancer and there isn't a lot of research dollars sent that direction.

Any suggestions on seeking help?

The surgery went pretty well otherwise. Should be releasedd thursday or friday.

Bill

Bill