Posted By: MaherC CT Scan findings - 11-01-2008 03:19 AM
I'm a 42 years old male, about 5 month ago, I had a severe sore throut very hi fever that would not come down with Motrine Tylonol. fever mantained 40 C degrees and with motrain will stay at 39.5 C. It all started on Thursaday with a feeling of havenies in my throut and by friday morning I woke up with chilles hight fever and sore throut that will radiate to my ears wehn trying to swallow. I spent all friday and all night with hight fever and sore throut. on Saturday I went to doctor and they did a culture for streo throut that came out negative, the throut was red but no other findings. the DR gave me an antibiotics shut and pills for ten days and asked to come back the next day if things stay the same. fever went down to 38.5 C with 3 pilles of motrain at a time. The next day i went back for the second antibiotics shut and gradully by monday the fever started to subside but the sore throut took about 2 weeks to get better. since then and for about a month I always had pain in my right side of my front neck that is vertical and into my jaw and occanssional dull ache in my ear with stiff neck and ache throut.

about four weeks after this, I went to my doctor for the pain that I'm having so she orderd a CT scan for my neck. the result of the ct scan showed Mildly enlarged Lymph nodes scattered on both sides of the neck roughly equally on both sides and are present in the submandibular region, the largest node on the left measuers about 1.05 CM and is seen anterior to the Jugular vein at the level of the hyoid. There is also soft tissue prominence in the area of the valleculae.
The conclusion of this scan was: Some Cervical adenopathy is present and appears to be fairly symmetric side to side, there is also soft tissue Fullness at the region of the base of the tongue and Valleculae, this may also relate to lymphoid hyperplasia, althought it is difficult to exclude a mass in this region, Correlation with direct visulization is recomanded.

My Dr reffered me to ENT and I was seen by his asisstance who preformed a endoscopy of my nose and throut and told me that she can see some fullness and the area is irretated. after telling her that I have reflux and I take omeparzol for it she gave me a dose of 2 weeks Amoxilene 825mg and asked me that I take my reflux medication and repeat the CT scan after 3 weeks.

I so did, after 4 weeks I repeated the CT scan in a different facillaty then the first sacn. and was scheduled for an appoitment with the ENT after two weeks, the 2nd scan result showed the following:

Base of the tongue mass which occupies the vallecula bilaterally althought silghtly larger on the right. The mass mesaures 2.5 CM in transverse X 2.0 CM in AP dimension.

Bilateral level II to level IV lymphadenopathy. the largest on the left jugulodigastric lymph node measures 1.6 CM and the largest on the right mesaures 1.6 cm, several subcentimeter level V nodes also noted bilaterally. small posterior neck nodes are noted the largest on the left measureing 1.0 CM

Conclusion was :

1- Base of the tongue/vallecular lesion consistent with head and neck squamous cell Carcinoma, Lymphoma is also a possible differential consideratin, Biopsy is Recommended.

My ENT DR called me and asked me to make may visite to his office this week rather then in 2 weeks.

I went and he took another look and he told me that he is not 100% convenced that it is cancer and he wantetd me to go for a biobsy in 2 weeks. when I asked him what is persantge he said 50/ 50 %.

So is it possible that after the CT scan indicated that the Mass is consistant with cancer to come out negative? has anyone know of such incident where the CT scan say cancer but it is not?
Posted By: ChristineB Re: CT Scan findings - 11-01-2008 03:26 AM


Welcome to OCF.

I am not a doctor or even anyone with any medical background. I just know that a biopsy is the way to tell for sure if it is cancer. Im sorry if my answer isnt more helpful. I do know how awful it is waiting for a test and then the results, its a very frightening time which seems to last forever.

Hope everything turns out to be negative.
Posted By: MaherC Re: CT Scan findings - 11-01-2008 03:53 AM
True, it is fustrating and I already feel that it is indeed cancer, the odd thing is that 2 CT scans one month a part with two different findings, also I have not seen one case during my research that a CT scan indectaed Cancer and the biobsy came negative. The other odd thing after my last visit to my ENT the symptoms increased and the pain is worse althought it is better at times.
I guess I can predict the biobsy result giving the circumstances and I'm not sure why the ENT after looking in said it is 50/50 chance that it is cancer.
Posted By: DonB Re: CT Scan findings - 11-01-2008 04:23 AM
MaherC,
If the biopsy confirms Head & Neck cancer, you want to make sure your treatment is provided at a Comprehensive Cancer Center by a multidisciplinary team that routinely deals with numerous H&N cancer patients and uses state of the art RT systems.

This link provides CoC Accredited Cancer Center Hospitals and NIC Cancer Centers. Many show their annual case load by cancer type.

http://www.cancer.org/docroot/FTC/ftc_0.asp?sitearea=ETO
Posted By: Susan2992 Re: CT Scan findings - 11-01-2008 05:07 AM
MaherC,

As Christine said a biopsy is the only way to know for sure. I truly hope that the biopsy comes out negative. I've been in your shoes and the waiting is awful. If the news is bad, follow Don's advice and seek treatment at a Comprehensive Cancer Center if possible. This website is an excellant source of factual information and also moral support.

I hope you get good news!

Posted By: davidcpa Re: CT Scan findings - 11-01-2008 10:30 AM
You need to get the biopsy done and put all the questions to rest. They will most likely put you under and you should have the results by the time you wake up. At least that's what they did with me.
Posted By: MaherC Re: CT Scan findings - 11-01-2008 12:14 PM
Thanks All,

I looked into the Site that DonB provided there is few hospitals in my area as a matter of fact the ENT that I'm seeing is in one of them.

The strange thing when I looked into the case load, the numbers were very low for the Oropharynx cancer, the Hospital I will be doing the Biopsy at , had only 1 case diagnosed in 2006, so I guess this cancer is realy rare.

As for the biopsy it is scheduled for next Wednesday Nov 5. I hope I'll get the results that day like Davidcpa said. and I realy hope it will be negative, but again as I said with CT scan indecationg that the Mass is consistant with SCC, I think but dont hope that it will be positive since again as I said I have not seen a case with such CT Scan Findings that a biopsy came back negative unless it was a false negative.

Have any of you heard of such?
Posted By: EzJim Re: CT Scan findings - 11-01-2008 12:37 PM
Welcome to our world of friends in time of need. As has already been stated, the biopsy is the only way to be sure.
Posted By: Pandora99 Re: CT Scan findings - 11-01-2008 02:59 PM
Welcome to OCF. You are doing all the right things - staying on top of it and, like all the other said, there is no way to be sure without the biopsy. I am not aware of others who have had exactly that situation, but often by the time people arrive at OCF, they already have the diagnosis and don't relate the how they were initially diagnosed.

Breathe deeply - you're on top of it and we're here for you.

Donna
Posted By: Pete D Re: CT Scan findings - 11-02-2008 12:36 AM
Until they take a piece of it and put it under the microscope to see what kind of cells are present, they really don't know.

In my experience, David got really good biopsy service -- I've always had to wait awhile.
Posted By: Gabe Re: CT Scan findings - 11-02-2008 01:53 AM
A Welcome to OCF from me as well.
I have only ever had biopsies from my first visit to oral surgeon in 2006 to now. (No CT/PET.) I remember having to wait for at least a week before I got the result. Phone call while I was at work frown
Hope your results brings only good news. Good luck.
Cheers
Gabriele
Posted By: margaret_in_ma Re: CT Scan findings - 11-02-2008 03:56 AM
Like others here, I'm not a doctor or medical professional, but I am a very experienced cancer patient... the thing is, the CT scan machine can't diagnose anything! All it can show is where any tissue abnormalities are but it cannot show any more than that. As others have said, the only definitive way to diagnose cancer is for a pathologist to look at cells under a microscope.

My pathology results took a week after my biopsy.

- Margaret
Posted By: DonB Re: CT Scan findings - 11-02-2008 04:30 AM
My symptom was a swollen lymph node, so I had a biopsy the same day I first saw the ENT. It took about a week for the results to come back and then in short order he schedule a CT, followed by a PET/CT, then surgery

Regarding your local CoC Cancer Center's light caseload for oropharynx cancer, you should be able to add Tonsil cases since they group these separately. Some of the tongue cases are probably Base-of-Tongue which is also the oropharynx region. I would also recommend you ask since just one case makes me uncomfortable.

For reference the CoC Comprehensive Cancer Center I went to has capacity for 60 H&N cases a year at the Center and another 40 (using standard IMRT) at their hospital based satellite centers.

Several of the NCI Centers report a H&N caseload two to three times that amount.

Posted By: MaherC Re: CT Scan findings - 11-02-2008 02:32 PM
I think with the symptoms I had and with the first CT scan that did show swollen lymph nods, they could've saved me sometime and did the biopsy much earlier. The first visit to the ENT after the first scan, I was seen by his assistant, she looked through the endoscopy and she said that there is some fullness at the base of the tongue repeating waht the first CT scan report indecated and she said that the whole area was irritaed and gave antibiotics and told me to this could be related to Acide reflux as well and asked to repeate the scan after 4 weeks. so if I think the ENT DR not his assistant saw me that day he could've orderd the Biopsy much earlier at least 3 weeks earlier. so I'm not sure if that assistant missed seeing the Mass or there was no mass at that time and now I wonder couldit be possible that the mass got larger that fast that became 2.5x2 cm?
Posted By: davidcpa Re: CT Scan findings - 11-02-2008 02:51 PM
Don't know the actual comparison numbers but Primaries (cancer starting point) involving the Tonsils and Base of Tongue, the Oropharynx region, are not that uncommon and more often than not test positive for HPV, especially if tobacco use is not in the patients history.

But again you need to get the biopsy to confirm cancer in the first place.
Posted By: Charm2017 Re: CT Scan findings - 11-02-2008 10:16 PM
My ENT gave my wife the her interpretation of the biopsy right afterwards while I was still unconscious in the recovery room as Cancer tumor. Stage IV etc. That was based on her experience and the CT scan. The formal pathology reports confirming cancer came in later next week. Good luck. For what it is worth, it took a year for my cancer to get diagnosed after antibiotics, sinus, eardrops, etc.
Posted By: azcallin Re: CT Scan findings - 11-04-2008 06:48 PM
ct is open to interpretation by the one reading it, thus one of the reasons a biopsy is so important and reported as the only sure tell way of knowing. a mass showing on a scan can be from multiple factors. the cancer theory may be correct but never accept that diagnosis until you have to (ie: have it confirmed by biopsy). Best wishes and keep us posted smile
Posted By: MaherC Re: CT Scan findings - 11-05-2008 11:13 PM
Had the biopsy this morning, for some reason did not freeze it and will not know the result until my next appoitement in 2 weeks. so basicly I have another 2 weeks to wait.

Shouldnt they looked at it under the microscope today? why did nt they do that?
Posted By: EzJim Re: CT Scan findings - 11-05-2008 11:43 PM
I must have been lucky, Surgeon confirmed what I had thought, and within a week, it was confirmed and I was moving like I was just shot out of a cannon. Just had a 3rd CtScan in less than 3 weeks today. This has me wondering what is going on in this stomach to cause so much pain and a nice size lump that seems to be causing it.
Posted By: azcallin Re: CT Scan findings - 11-06-2008 12:06 AM
maherC they most likely send it to the lab rather than having someone on site to look at it... and even when they took samplings at time of my surgery it took about 10 days to get report back and that lab was in the same hospital ... i know it is hard to wait - the unknown is the hardest part but hang in there and keep your mind busy on other things as much as possible so time passes faster. fingers crossed for good report!
Posted By: davidcpa Re: CT Scan findings - 11-06-2008 01:21 PM
I wish you would have gotten that answer before you went under. Now it's to late. Maybe your insurance played a role?

Waiting sucks and with today's technology we shouldn't have to without a good reason so I would ask. Make sure it's a good reason. When my ENT did a FNA on my neck node he said, "I'll pull some strings and get it back ASAP". Two weeks to the day I got a phone call to come in to see him AFTER he was finished with the day's appointments. I knew it wasn't going to be good news.

When they put me under to find my Primary, my wife had the results before I even woke up. That's the way it should be.
Posted By: Charm2017 Re: CT Scan findings - 11-06-2008 02:41 PM
While hoping that your biopsy comes out negative, if it is positive, then consider getting a second opinion on treatment from a CCC. Based on your description of level of care so far, it would be time well spent. The caseload statistics are all very well and good but they don't show how many of the diagnosed cases were treated successfully. I stuck with an RO whose administrative staff and facility scheduling were much less than optimal based on his amazing track record of cures for Stage IV.
Even thought there is no Stage V, there is still HOPE for a complete remission even if your diagnosis was as late as mine ("guesstimate" that tumor had been growing for six years before spreading to lymph nodes in seventh year)
Good luck
Posted By: azcallin Re: CT Scan findings - 11-06-2008 06:40 PM
David - The results I had to wait for after surgery were the ones to tell me if they got clear margins etc. I already had the biopsy results etc long before the surgery ... sorry if I was unclear on what I meant. Was just relating to the thing of taking a while to get reports even when they were doing it onsite... guess each place is different and some move faster than others. My first biopsy report took 4 days to get back and they sent it to a Kansas Univ. from WA to test ... so not a bad turnover time ...
Posted By: davidcpa Re: CT Scan findings - 11-06-2008 10:01 PM
Oh, I see but waiting still sucks.
Posted By: MaherC Re: CT Scan findings - 11-07-2008 12:59 AM
I was expacting to have some results after I woke up my biopsy was done at the Kansas university medical center my ENT is a Head and neck cancer specialest, before my proceduer I spoke with him and he indecated that he might not freez any sections to keep the tisue intact. I think and from what I read in his dictation from my last vist, he could not see a distinct toumer and I think that is the reason that no freezing was done since the mass is still under the upper lining. I dont mind the wait if good news will follow.
Posted By: azcallin Re: CT Scan findings - 11-07-2008 06:12 AM
yes, yes it does ... waiting and the unknown are the worst two things to handle ...
Posted By: ChristineB Re: CT Scan findings - 11-08-2008 03:31 AM


My experience with biopsies are that it takes about a week to get test results back. Its not easy waiting, try to keep busy so you dont waste time worrying. It wont change the outcome anyway. Think positive.
Posted By: darkeyedlady0 Re: CT Scan findings - 11-08-2008 05:19 AM
I agree with Christine...from what has already commented on this site several times Don't let cancer steal any more from you and the more you worry about results the more is stolen. It is difficult very difficult to live in the here and now...

For me it was two weeks+ after my final surgery to find out if I was all clear. "all clear" "clear margins" "no further treatment required" The sweetest words I think I have ever heard!!! A round of hugs and thank yous!!!!
Posted By: MaherC Re: CT Scan findings - 11-20-2008 04:49 AM
Today I got the Biopsy results back, it is Squamous papilloma so no cancer at this time, the bad news is that while I was waiting for my results, my wife was diognosed with Multiple myeloma and she is in hospital unable to walk with sever back pain.
Posted By: azcallin Re: CT Scan findings - 11-20-2008 11:06 PM
Oh, MaherC My heart breaks for you both.. what a hard time. On one hand we rejoice with you that your results are a positive piece of news, while your wife gets handed a real blow.

I had to go look that up, as i had not heard of it before. One thing I note is that while it is not curable (YET) it is quite treatable most times, making life worth living for those suffering from it, and extending life time for them as well. so, be of good courage that there is hope for your wife.

I will say a prayer for your wife, and I would encourage you to advocate for your wife - pain is not easy to deal with and if she is not getting relief, keep on the staff at the hospital to find something else to try... she needs relief to cope

Please keep us posted and I will keep you both in my thoughts and prayers.
Posted By: wilckdds Re: CT Scan findings - 11-20-2008 11:37 PM
Maher,

I was happy to hear the good news for you and I am sorry to hear that your wife has multiple myeloma.

In Jan. 2002, one of my partners in my dental practice was diagnosed with multiple myeloma. He has had some ups and downs and is still practicing dentistry full time. There are many treatments available and one may work for quite some time and then a switch to something else can be made.

There are support groups on the web and if I can help you in any way, please let me know.

Jerry

Posted By: MaherC Re: CT Scan findings - 11-21-2008 02:22 PM
Thank you Jerry, I would appreciate all the help I can get
Posted By: wilckdds Re: CT Scan findings - 11-22-2008 03:09 AM
This site is probably the most informative one that I know of. I have been doing their local walk in Philadelphia for several years and they have raised a great deal of money for research. http://www.multiplemyeloma.org/

If you or your wife have specific questions, I will discuss them with Jeff. If you would like, I will ask him if he would be able to communicate directly with either or both of you.

Jerry
Posted By: MaherC Re: CT Scan findings - 11-22-2008 04:01 AM
again thanks Jerry, We have lots of questions and meny things to learn and your offer would be a great help.

We are still gathering information about her condition.

I spoke to her DR today and went through the lab report and MRI and Xray there is some starnge things that needs clarification I will prepare a list of things that could be helpful in making sence out of all of the things that is going on.

Thanks
Maher
Posted By: EzJim Re: CT Scan findings - 11-22-2008 10:44 PM
I remember waking up at Ohio State James James Comprehensive Cancer Center on Aug 3rd of 2007 and being told I didn't need rads or chemo because all of the cancer had been gotten. Knew that was wrong by the feel in my mouth. Dec 2007, more biospsies , part of right side joined the left side and took a walk. Was then told I needed rads and chemo. Lost my teeth, had rads and chemo after and then rad seed implants in my tongue..But as they say,, I am alive and kickin. Stll have problems but still laugh and enjoy life as usual.
Posted By: azcallin Re: CT Scan findings - 11-23-2008 05:08 PM
you are such a great source of inspiration, Jim. Keep on keeping on ... and trust your gutt. I pray your problems diminish and your enjoyment in life is enhanced and you live a long, happy life, with lots of laughs included smile
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