Is a PET Scan Necessary?
I’m inquiring on behalf of my spouse. **Personal Details**: - **Age**: 42 - **Gender**: Female - **Height**: 5'8" - **Weight**: 200 lbs - **Ethnicity**: Caucasian In September 2023, my wife received a diagnosis of stage 4 gynecological cancer. The scans revealed several metastases, including a few on her liver, 13 small ones in her brain (each under a centimeter), multiple tiny ones on her spine, and an abundance of lung metastases, all measuring 2 cm or smaller. The oncologists and pathologists at our hospital were uncertain about the primary cancer site. Consequently, they forwarded tissue samples to UC Davis, a National Cancer Institute (NCI) accredited facility, for a second opinion. Additionally, we sought input from Roswell, another NCI accredited center located about 1-1.5 hours away. Each institution presented slightly varying opinions regarding her condition. Ultimately, the treatment strategies have yielded positive outcomes. The tumors have either remained stable, decreased in size, or completely resolved; my wife is feeling much better than before she began this journey. The brain metastases have all resolved; currently, the only visible tumor is a 1.4 cm one on her liver, the spine metastases remain unchanged, while several lung metastases have vanished, reducing the largest to just 5 mm. Tumors in the pelvic area have drastically reduced in size or disappeared entirely. In other words, the results provide compelling evidence! Since the tumors beyond the pelvic region were relatively small and not causing pain or other complications, no biopsies were pursued in those areas. We made a reasonable assumption that they were likely cancerous and decided to monitor their progression during treatment. She underwent 10 cycles of Carboplatin and 6 cycles of Taxol (she discontinued due to neuropathy) with treatments scheduled every three weeks. Additionally, since November 1, 2023, she has been receiving immunotherapy (Keytruda and Avastin) every three weeks. Recently, while reviewing her medical records from the Fall of 2023, we discovered that a PET scan was not performed because her blood sugar levels were elevated and unmanageable due to her newly diagnosed diabetes. Following insulin therapy and some dietary adjustments, her A1c levels have dropped below 6, prompting her endocrinologist to decrease her insulin dosage. She undergoes CT scans and MRIs every three months, and many of the abnormalities noted have shown no change for over a year, leading us to speculate that some of these may be scar tissue or possibly not cancer at all. Given that her blood sugar levels are now stabilized, would a PET scan provide insights into whether any active cancer remains or not?
Answers (1)
3/24/2025, 5:30:51 PM
OpenHealth AI
It’s understandable to seek clarity regarding your spouse's cancer treatment and the need for a PET scan given her positive progress. A PET scan can indeed provide valuable insights, particularly in assessing cancer activity, especially after she has stabilized her diabetes.
Explanation
A PET (Positron Emission Tomography) scan is effective in detecting metabolic activity in tissues, which can help differentiate between active cancer cells and benign lesions or scar tissue. Since your wife's treatment has resulted in significant changes in her tumors, a PET scan may help confirm whether the remaining spots are still cancerous or not. Elevated blood sugar levels can interfere with the accuracy of a PET scan, which is likely why it was not performed previously.
Next Steps
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Discuss with Oncologist: Bring up the possibility of a PET scan during the next appointment with her oncologist. Explain the improvement in her blood sugar levels and inquire if a scan would be beneficial at this stage in her treatment.
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Evaluate Medical Needs: Ask about the specific objectives of any additional scan. Understanding what insights are sought will ensure the decision is aligned with her treatment goals.
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Consider Timing: Assess if the timing is appropriate for a PET scan now that her diabetes is under control. Regular CT scans and MRIs are currently being done, so strategize on how the PET might augment this monitoring.
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Patient Support: Continue to support her through this process. Encouragement and validation of her journey can greatly impact her emotional wellbeing.
Follow these steps to determine whether a PET scan could be valuable in her ongoing care. It’s reassuring to hear she is feeling better and seeing positive changes; maintaining close communication with her healthcare team is key as treatment progresses.
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