I have included the full body of the CT scan report below (I may retrospectively add previous reports in the future). The report shows “a minimal decrease in size of the right upper lobe neoplasm“. This is the first scan since commencing treatment and follows the previous scan that was immediately prior to treatment and which had showed some slight growth.
The oncologist registrar explained that it is not possible to tell from the scan to how much of the abnormal tissue in the lung is necrotic mass (dead tissue).
No change in the abnormal kidney mass and the registrar also suggested that it can’t be certain that this area is a tumor. The report suggests that ultrasound could be contributory in deciding the nature of this tissue, so I will discuss this with a doctor at a future consultation.
The scan does not reveal much about the status of the 12th rib area pathological fracture area, but I have not needed pain killers to deal with this for some time now (weeks).
As the scan indicates that the chemotherapy is at least holding back the lung tumor and seems to have caused some slight regression, the current therapy will be continued for a further three cycles (cycle 4 commenced today). After this time the tumor will be again measured and ongoing monitoring of it and my general health will continue until such time as further growth may be detected in which case, a different chemotherapy regime would be considered. A further scan would normally be scheduled at about 3 months after the current schedule of chemotherapy has been completed, unless some cancer progression is indicated by further symptoms.
CT CHEST, ABDOMEN & PELVIS
Clinical history: Stage 4 NSCLC right upper lobe three cycles chemo, progress.
Findings: A multislice examination of the chest, abdomen and pelvis was performed after non-ionic intravenous contrast.
There is still a lobulated, partly necrotic mass in the medial right upper lobe, today measuring 2.7 x 2.4 cm x 3.2 cm in the craniocaudal direction, a slight decrease in size since 15/2/07.
Changes of emphysema are again noted in both upper lobes and there is only a 1 cm node in the superior right hilum that is within normal limits for its size. No new lung lession is identified and there is no pleural pericardial effusion. The destructive lesion in the head of the right 12th rib is again noted.
Small liver cysts are unchanged since previously. the 2.4 cm mass in the lower pole of the right kidney is not significantly changed. Follow-up with ultrasound could be contributory in deciding if this is a solid mass. No retroperitoneal or mesenteric nodes are identified and no new pelvic lesion is seen.
Conclusion: Since the previous examination of 15/2/07 there has been a minimal decrease in size of the right upper lobe neoplasm. No other change is identified.
Sample images from this scan:
I have included two slides from the set that show the lung tumor as this is the primary tumor, and seems to be the most threatening area of activity at this time and no changes seem to have been noted in other areas of investigation (kidney and bone).
Sample slides from the original diagnostic scan are included in a previous post.