PET scan or wait another 2 months for 2nd CT?

History - he had a prostatectomy via DaVinci 3 years ago and had lots of scar tissue issues for the next 2 years. Lots of pain as they had to go in and stretch the scar tissue in his urethra every 2-6 weeks. It finally worked and that issue is some better.

He smoked for 20 years and quit about 27 yrs ago. He is about 40 lbs. overweight and diabetic.

He had been walking 1-2 miles 3 days a week and riding a stationery bike 6 miles the other 4 days. About 2 months ago he started having shortness of breath and had to stop walking. He had a lung x-ray, then a CAT scan where they found 2 spots 9mm and 4 mm in 2 different lobes. Last week he went and had pulmonary function tests; repeated tests after using an inhaler was 15-20% better. Dr. talked to radiologists and they said it was up to hubby (they didn't have strong opinions either way) as to whether he has a PET scan now or wait for 2.5 months and have another CAT scan. He has decided to wait and do the CAT scan in August with the comment to me "Even if they find something, I probably won't do any treatment."

He also seems to have developed a cough, and has noticed ganglions (calcium deposits?) developing on his knuckles. This past weekend all he did was complaiin about being tired and he napped more than usual.

Am I crazy or wouldn't it be better to do the PET now and if it shows activity, start treatment earlier than later? We have a 6 mo. old grandson and 2 daughters - I feel he's being selfish ... or am I?

By kq182
Posted June 14, 2009 at 8:52 pm
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Hi, he is definatly scared. If he truly means he will NOT have treatment then I guess he has made up his mind if he does have lung cancer. Knowing sooner or later, if he is not going to do it, there is nothing you can do except show him all the positive people on this site who have had treatment and are living and beating the dreadful, outdated stats. I would suggest to you to really have a talk with him and see if he would consider treatment if he has cancer, and if he says yes, then time should not be wasted, and I would want my husband to have a PET scan and see what he is up against. Good luck, sorry you are dealing with this, but hopefully we can be some help to you, Karen

By lakeluvr
Posted June 14, 2009 at 9:02 pm
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Thanks Karen
He knows I'm upset with him about his decisions, especially that he won't have the PET scan now. He has told one daughter about the spots and she's upset with him also. But from some of the posts I've seen on this board today, maybe waiting for another 7 weeks won't matter.

By kq182
Posted June 14, 2009 at 9:23 pm
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Waiting another 7 weeks will matter if he does have lung cancer, the sooner he has treatment the better, that is if you and your daughter can talk him into it, it is his decision, but really in 7 weeks alot could be done to help him with either radiation or chemo, also if it is lung cancer they need to biopsy it find out what kind to make diagnosis, and then arrange treatment plan, so all this takes time too, please try and get him to have the PET, good luck, just tell him how much you all love him and want the best treatment for him ASAP. Take care, Karen

By jazzbo
Posted June 14, 2009 at 9:26 pm
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Dear Lakeluvr. I'm one here to tell him to come on here and talk to me. I'm a nine year survivor and I've seen a lot of people come an go. I know that all the evidence and testimony is the earlier the diagnosis the better. It is a lot better and easier to deal with early.
Anyone who has thought or been told they have Lung Cancer is scared, petrified. We all know it's bad and it's not easy. The rest of your life is going to be what it is. But wouldn't you want to know either way so at least if without treatment you have only a little time left, don't you want to go on your terms and use what you have to say all those good bys and do what you want to that you never had time to do. To be at least fair to the rest of your family and give them time to do what they have to do to prepare for the inevitable.
Or how about gaining some knowledge about your treatment options and quite possibly look to a cure!
I've just recently attended my daughter's high school graduation and the night after I thought of something I hadn't thought of for a long time and that was
I told God that I would do his bidding if he gave me the time to see my daughter graduate from high school. So now I'm trying to pay this debt by talking to people who need an ear to talk to. Someone who has been there and am still there. We never leave this scary place ever because we've all seen the other side in one way or another and believe me it's much better here! - John

By lakeluvr
Posted June 14, 2009 at 10:12 pm
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Thanks John and Karen, for all your thoughts and suggestions. They said the spots were too small for biopsying (?), and said there was no rush to do the PET scan now over waiting for the CT scan in August. I'm like both of you tho - why wait if you can possibly find out now, regardless of your treatment decision.... One thing that I see in his favor is that the Albuterol inhaler seemed to help his Pulmonary Function Tests and he is now using it twice a day.

I just don't think I can wait til August to try to determine anything!

Is there anyone reading this that thinks perhaps what he IS doing is the right thing?

By jazzbo
Posted June 14, 2009 at 10:52 pm
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who is recommending the wait and see? The PCP or the pulmonary specialist? I'm just concerned about waiting when he has a history with cancer in it plus smoking for 20 years. I think I might want a second opinion from an oncologist. We here all I think agree the faster the better but sometimes you just have to grin an bear it. John

By HighlandGuy
Posted June 15, 2009 at 10:43 am
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Waiting three months(and possibly longer) is definitely the right thing to do.

Only a biopsy can determine if the nodule is cancer or not and if it is, the type and grade to assist in determining the course of treatment.

The purpose of a PETscan is to determine if the nodule is growing, hence the need for a biopsy!

Waiting three or more months and then taking a CET scan will tell you the very same thing that a PET will tell you, namely, if the nodule is growing.

If it is grwoing, and if it is big enough to biopsy, that is exactly what needs to follow. If there is no growth, you will have saved yourself a PET scan and possibly an unnecessary surgical procedure.

It should be noted here that in case a biopsy reveals cancer, some doctors may prefer a PET to bone and CT scans for staging the cancer (namely determining if cancer may have spread to other organs or (as in my cas) to reveal other cancers.

We need to use good judgement.

Your dad is right on the beam. You should know too, that in former smokers benign (non cancerous) nodules or tumors are quite common.

HighlandGuy

By lakeluvr
Posted June 15, 2009 at 3:02 pm
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Thanks Highland Guy for your input as well. We've been told that the spots could be scar tissue from either smoking in the past or from previous infections such as bronchitis etc. We just got the bill for the first CT scan and it was $1200 to us. Found out that my Cobra coverage changed in April to a $7500 deductible and hubby about had a fit!
I'm sure now that he'll wait for the CT scan in August. Now if I can just be patient ......

By cuddles53
Posted June 15, 2009 at 3:15 pm
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I think I tend to agree with highland guy, they can not biopsy now so why have a CT done now, it will only be to find out sooner, but with nothing to be done about it, give him some time to think things through. Some people, myself included were not sure what to do, my first reaction was total fear, I had to take some time to think it out for myself first, have patience with him that he can make up his own mind, especially in this case when they are so small. He will not disappoint you I am sure, and if he does well so be it, it is his decision to make, and I can not see anyone being pushed into something or even eased gently into something because that is your wish, it should be up to him, this is his body, he can certainly use some help in helping him find a solution, but I think the best thing would to gently let him come to his own decision, and just be there supporting him in whatever decision he makes. May God bless you all going though this.
Sandy

By sheilake
Posted June 15, 2009 at 5:48 pm
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The nodules are small now. Nodules need to be big enough to do a biopsy. Three months will tell the tale about whether they are growing. (Just for your information, though, my right lung tumor grew from nothing to 5X6CM in eight months.) Based on that, I wouldn't wait any longer than three months.

PET scans are much more expensive than CT scans (approx. 5X) If you are paying the bills to $7500. you might consider the CT scan over the PET scan.

Your husband can change his mind about treatment if he has some options that appeal to him. I refused chemo and started Tarceva when I found out about it. It has given me an extra seven months and I am still going strong. Some treatments can actually improve quality of life. Tarceva did for me.

Sheila

By HighlandGuy
Posted June 16, 2009 at 3:51 pm
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Twelve hundred dollars is attrocious, when the standard cost is about $300. It's another arguement for revision of our healthcare system.

On CNN yesterday AM it was noted that in a city in Texas (I believe it was MacAllen), with comparable population, the average annual cost of treating a senior was $16,000 as compared with $6.000. in my city. I feel with one teaching clinic/hospital employing 6.000 employees and a Mayo affiliate employing 3,000, we have some of the best medical care in the country.
I know they watch over me like a newborn babe!

I realize it is always a concern waiting. I have had several such situation and fully appreciate you anxiety.

Hang in there and I am sure you will do fine.

HighlandGuy

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