Lung spots forming DURING chemo?

[ryan1]

Hello everyone,

I’ve just finished my last cycle of 4xBEP last week. My AFP level has now normalized from 3300, and my HCG from 1400.

And the bad news: I went in for my post-chemo CT scan and 3-4 2mm “nodules” have been seen in my lungs. My pre-chemo CT scan and chest X-ray showed nothing. How could this happen? I’m currently being scheduled at IU for RPLND, as my tumor has remained soft ball sized.

Does the fact that such a thing happened during the administering of chemo mean that my cancer has grown resistant to the drugs, even though my markers decreased with each session?

My PT was 90% mature terratoma and 10% yolk sac.

Thanks for any help with this

[IowaBrian]

Sorry for the news and good luck with the surgery.
The 2mm nodules would be very small I wonder if they just weren't picked up by the first scan? Was the scan on the same machine? How much time between the scan and the start of the chemo? I would think there could be a number of reason they weren't picked up if they were so small on this scan. Just my $.02
Good Luck
Brian

[dadmo]

With your markers normalized and such a high percentage of teratoma I would not assume cancer. At some point the doctors will most likely want that removed. I know, that stinks.

[Lori]

Hi Ryan, first congrats on finishing the chemo! My husband also has majority teratoma (immature), 10% Seminoma and yolk sac. He had small 1-2mm nodules on his lungs in the first CT Scan and none noticable on the 2nd. Our doctor said probably not cancer due to the large amount of teratoma. He thought maybe calcium deposits?

I'm curious if your AFP markers did a consistent decline during your chemo if there was some up and down?

Good luck with the RPLND! Stay strong!

Lori

[ryan1]

Brian- I had my original ct scan on a Thursday, and then started chemo that Monday. I thought maybe they were undetectable before also. It was done on the same machine which buy the way the assistant nurse told me was supposed to be a “good thing” when explained to me her logic was that since this machine took fewer “slices” (pictures) so I would receive less radiation.

Lori- thank you. Well, my AFP markers went up about 300-400 after my IO, after that they were on a steady decline.

[Fish]

Hi Ryan;

CT scans of the chest are notorius for finding things that are nothing to worry about. Three months after my seminoma diagnosis my CT showed a 5x7mm lung nodule. So we waited and worried. Three months later the nodule had decreased in size. Since then it has been noted in some, but not all, of my scans. My oncologist said the CT's are almost too sensitive for the chest, and that a lot of people might have these abnormalities in the lungs and never know it.

So, I wouldn't worry too much, just keep monitoring.

Best wishes

[Scott]

That's a major reason why chest x-rays are preferred over CT scans for surveillance.

[IowaBrian]

Something I forgot to mention: Like my doctor told me he is paid to worry so I don't have to ... unless he tells me to worry. so with that if the doctor hasn't said that he or she is worried about the finding you shouldn't be too worried
We still have to question the doctors but we also have to trust them that they know what they are doing, and know what is best for us.
Brian

[Scott]

Like my doctor told me he is paid to worry so I don't have to ... unless he tells me to worry.

I know the doctor meant this in good humor, but here's my take. Yes, we should trust our doctors and believe they're looking out for us. We should also remember that we are far closer to the problem and directly affected by decisions, so we have to be active participants. "It's your life. Take no prisoners."

[IowaBrian]

I agree
Brian

[MRM]

On a couple of my chest X-rays, doctors noticed some "prominence" in the blood vessels of my lungs, which led them to call for a chest CT.

The CT found 2 nodules-- 1.3 cm and 3 mm. But on the followup CT 2 months later, the spots were gone.

Try not to worry. The might be teratoma, but there's a good chance they are nothing. They might even disappear.

[ryan1]

Well I’ve just gotten some concerning news today. It seems my HCG levels have risen to 64. Evidently, there is a possibility that this could be caused by insufficient testosterone production, which is controlled by a chemical in the brain (FSH? I think). I got a shot of testosterone today, and will check may markers again in 10 days. If they rise- cancer: if they come down- no cancer.

Hopefully I will be in Indiana at that time anyway. My oncologist is going to speak personally w/ Dr. Foster on Monday. He seems to think that there is a good possibility that cancer could be hiding inside my 12X18cm tumor. I can’t tell you how anxious I am to get this thing out of me, I’m sure I’ll lose at least 5 lbs.


Thanks very much for the replies; I’ll let everyone know what happens.

[Karen]

ryan,
Sorry to hear that...testosterone could be the culprit. Check out the thread started by Don entitled "Not the results I wanted!!!!! " He had quite a wild ride with HCG and the testosterone made a difference. I pray that this is T-related and will resolve itself. Hang in there!

[indiana9]

Ryan,
First of all, the odds of your lung nodules being cancerous following 4 x BEP are infinitesimal. I had similar blips show up on my CT scan following chemo and Dr. Williams, my oncologist, said that if anything, they were small calcifications due to the bleomycin. From what I read these calcifications can occur in 6 to 10% of those who receive Bleomycin. Secondly, Dr. Foster is the BEST in the world. I too was in the softball sized tumor club, but mine shrunk to baseball size after 9 weeks of chemo and then showed positive for cancer during a PET scan following chemotherapy. Foster removed the big tumor, saved my kidney, preserved my sexual plumbing and came in after the surgery to tell me that my PET scan was a FALSE POSITIVE and that only necrotic tissue was left when he removed the tumor. Try not to worry, but do ask your doctor a lot of questions. While the rising HCG would certainly be a concern, you are going to survive this journey, and YOU WILL have your life totally back to normal before you know it. Take it a day at a time and LIVESTRONG!
Brian