New lymph nodes were discovered during post treatment PET CT

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Hello everyone,

Happy New Year! I wish you all a healthy new year!

My father was diagnosed last summer with nasopharyngeal carcinoma and several neck lymph nodes affected, including a supraclavicular lymph node. He had a PET CT before starting the treatment to confirm there were no distant metastasis and it was all good. We had 35 RT sessions + 4 rounds of Cisplatin, he finished the last one at the beginning of November.

On Jan 10th he had his follow up PET CT to check if the treatment was successful or not and unfortunately, the PET CT scan came back with a "surprise". The tumor was gone, all the involved lymph nodes were gone, there is no sign of cancer in any other vital organs, however, they have found 3 lymph nodes in the hilar and mediastinal area (chest). These lymph nodes were not there before starting the treatment and of course the doctors don't know if these are remaining cancer lymph nodes from the initial tumor or if they are caused by an infection or something inflammatory. A endoscopy biopsy was suggested, but my father is still thinking if he wants to do it or just watch and wait for the following 2 months, before he can have another CT scan.

I was wondering if anyone else experienced this or heard of anyone who experienced this?

When I first saw the PET CT results I thought of lung metastasis, since the lymph nodes appeared in that specific area, but I assume this would have been captured on the PET CT scan. The oncologist confirmed the same, but I have to admit that I have all sort of thoughts running through my head.

Thank you in advance for your help.

Mihaela

  • Hi Mihaela, sorry to hear your news. I had a hotspot on my post treatment PET but not in the lungs. I had it biopsied. My reasoning and my oncologists was that the sooner they knew what it was the sooner remedial action could be started if it was needed. Thankfully it wasn't. Give your dad a hug from us all here. xx

    Dani 

    Base of tongue cancer. T2N0M0 6 weeks Radiotherapy finished January 2019

    I BLOGGED MY TREATMENT 

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  • Hi.  That PET scan is only 2 months after the end of treatment.  It is quite likely that what is being seen is either an infection or some artefacts from the treatment.  My PET scan picked up a jaw infection under a tooth post treatment; so it does happen. 

    Personally I would listen to your clinical team as they are expert in understanding what is going on in the scans.  I had to make a similar decision recently and wanted to watch until my next review, but the surgeon was insistent he went ahead ASAP.  In the end there was nothing there, but I did get peace of mind.  If they are suggesting further exploration I would go with that.

    Peter
    See my profile for more details of my convoluted journey