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Effectiveness of FDG PET in METASTASIZED LOBULAR CANCER.

Resolved Question:

Thank you for the medscape article.  It was interesting.  But, it never really answered my question.

I wqs hoping to get (from you) an opinion or guess on how effective the FDG PET modality is on lobular cancer that has metastasized.  One doctor told me 95%, but I'm not sure that can be true because of the way lobular metabolizes glucose.

Would you be willing to give me your best guess? 


Category: Oncologist

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Category: Hematologist
Dr. Prasad Eswaran is online now

Expert:  Dr. Prasad Eswaran replied 4 Days.

Hello.
Thank you for your query at DoctorSpring.com
I had sent you an article written by an expert which gives evidence based sensitivity and specificity values of an investigation in breast cancer, primary site and metastatic lesion.
Honestly, i am not a great expert and I cannot guess an arbitrary value, but a PET CT can detect upto 80 percent. Values can vary.

Regards,


Patient replied :

I just had my 11th carbo taxol treatment and I just, for the first time, developed neuropathy in both feet. It is not painful but it makes it feel funny when I walk. I am worried that it will be permanent or even get worse.
I am also wondering if I should skip the final (12th) treatment, so that it does not get worse.
How likely is this neuropathy to remain, and not get better? Should I skip the final treatment?


Expert:  Dr. Prasad Eswaran replied 3 Days.

Hello.
A funny feeling neuropathy is probably grade 1. You can proceed with chemo and finish it. It is usually short term complication and will improve over a month's time.
Regards


Patient replied :

Thank you for your answer. I have another problem, that I just read about--it said that a fast heart rate can be a serious neuropathy that never goes away. I have had a fast heart rate ever since I started chemo.
Can other things in chemo (neupogen, chemo drugs) just give you a fast heart rate? Or do you think this could be another neuropathy? My heart rate has always been in the 80's--all my life, but now it is 105 or even 115 sometimes. It is 105 right now. I am worried if this is a neuropathy that will not get better, because it will be bad for my heart.
What do you think? Have you experienced people on chemo having continuous fast heart rates through the whole 6 months, and then having it get better?


Expert:  Dr. Prasad Eswaran replied 2 Days.

Hello.
I am not sure if this can be because of neuropathy. But in your case, can it be due to anxiety ? I am not sure. But fast heart rate is not injurious to heart unless the blood supply remains normal.
Regards.


Patient replied :

I have pain in my left thigh. I have had it since February. It is not bad and only comes sometimes. Never at night--except sometimes when I stretch in the morning. But, it is not something that I had before February. In that way it is new. I am afraid that it is a bone met. My doctor said that if it were cancer, the pain would be constant. But, I wonder if the chemo can partially cure the cancer, and then the pain would NOT be persistent? I had a pet/ct scan of course, but I do not trust it, because my cancer is lobular which doesn't work on the PET--and I'm not sure that blastic bone cancer would show up against my diffuse sclerosis (from dense bones)--where the background looks like salt and pepper. Do you think I should be concerned about this.
IMPORTANT QUESTION: for a bone scan to light up, do the bones have to be turning over DURING the scan, or does the scan pick up the RESULTS of previous turnover?


Expert:  Dr. Prasad Eswaran replied 1 Day.

Hello.
Cancer pain is not intermittent but a progressive breaking type of pain with increasing severity. By your symptom, I cannot consider this to be a bone pain which is further confirmed by your scan reports.
PET CT / Bone scan picks up activity based on different principles which is technically difficult to explain in email consult. It needs to be explained through lots of flow charts and pictures with complete illustartion.
I have already sent you an article on PET CT and this is on bone scan in https://www.inkling.com/read/nuclear-medicine-ziessman-4th/chapter-7/clinical-uses-of-skeletal
Regards


Dr. Prasad Eswaran
Category: Hematologist
Experience: 
Doctorate in Medicine (Fellowship in Oncology), DM,  Madras Medical College & Govt. General Hospital, Chennai, India.

Doctor of Medicine (Residency in Radiation Oncology) , MD, Christian Medical College, Vellore, Tamilnadu, India, 2004-06.

Diploma in Medical Radiology & Therapy (Residency in Radiation Oncology), D.M.R.T, Madras Medical College & Govt. General Hospital, Chennai, India, 2004-06.

Bachelor of Medicine & Bachelor of Surgery - M.B.B.S, Govt. Stanley Medical College & Hospital, Chennai, India, 1998-2004.
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