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Need help deciphering report…

› Forums › General Melanoma Community › Need help deciphering report…

  • Post
    • August 18, 2017 at 11:33 am
    Newmanbell
    Participant

      Hi all, my husband is Stage 3b, this is his first scan after starting yervoy 5 months or so ago.  He was only able to do 3 out of 4 treatments.  It has been a week and we still have not sceen doctor, can someone please help reading this?  We are not even sure exactly where these mets are in the chest.

      Head and Neck:  There is no nodal hypermetablism in the neck.  Physiological update seen in the oropharynx, salivary glands and larynix.

      Thorax:  There is no nodal hpermetabolism in the mediatinum.  There are no abnormal PET positive nodules in the lungs.  There has been resection of the right anxillary node, prior SUV 5,4.  There is a prevascular node with SUV 2.9, prior 4.5.  Index right hilar node has SUV 3.5 prior 6.0.  Left hilar node has SUV 3.5 prior 3.3.  There is a stable 3 mm pulmonary nodule in the left minor fixxure.

      Abdomen and Pelvis:  There is no hypermetabolism in the retropentoneum or pelvic hains.  The liver and spleen are normal in size and physiological activity.  Again demonstrated is large 4.6 cm photopenic hepatic cyst.

      Mulsculoskeletal – Marrow update is within normal range.

      Impression:  When compared with PET/CT of 02/02/2017 there has been resection of the right auxillary nodes.  Less FDG update is demonstrated in mediastinal nodes when compared with prior examination.  There is no evidence of PET positive disease in the abdomen and pelvis.

       

      Thank you in advance for helping us with this.  One question, is this a normal reduction in size with Yervoy?

       

      Donna

       

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    • Replies
        • August 18, 2017 at 1:19 pm
        ed williams
        Participant

          Hi Donna,  first off I am not an Oncologist but the way I read the report is that it is very positive!!! Any time SUV uptake is going down is good!!! Stable tumor size is also great news.  Every patient is different when it comes to how there tumors react to Immunotherapy drugs, some people will become NED while others like myself will have reduction of tumor size, then long term stable disease!!! Also the time it takes for the immune system to get going varies, hopefully by the next set of scans things will continue to improve. Have you done blood work lately and if so how did the #'s look compared to early blood work? Best Wishes!!!Ed

            • August 18, 2017 at 1:50 pm
            Newmanbell
            Participant

              Love you Ed for responding.  Issue with bloodwork is his anemia, thus not sure they are going to let him go on maintenance dose.  My concern is after 3 doses, how soon does it go out of your system and my understanding is Melanoma knows how to get around this after a bit.  Long term stable ike 20 years…:), would be awesome…he is only 62.

              • August 18, 2017 at 2:16 pm
              Bubbles
              Participant

                I think Ed's eval was on point.  As to durablity of ipi….while melanoma is a tricky beast….there is also cause for hope here as well:

                http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2015/03/ipi-for-melanomathe-data-keeps-pouring.html  

                http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2013/11/melanoma-patientsalive-and-kicking-10.html  

                I wish you and your husband well.  Celeste

                • August 18, 2017 at 3:47 pm
                Newmanbell
                Participant

                  Celeste,

                  All I did was compliment you this morning to my husband about how much you help all of us, you may never know how much we all appreciate it!  You rock!

                   

                  • August 18, 2017 at 2:25 pm
                  mrsaxde
                  Participant

                    Donna, like Ed, I'm not an oncologist or immunologist, but the info I've read says the half life of Yervoy is about 14 days. And as Ed noted, any time SUV numbers are declining and nodules are stable or smaller is a very very good thing! 

                    You are right, cancer is "smart," as Dr. Sharfman at Johns Hopkins tolld me. I had what was apparently a complete response to Keytruda. It got rid of nodules in one lung and killed several spots on my skin that are still there but no longer active. Unfortunately in my case my cancer reemerged in my chest lymph nodes a few months later.

                    But each person is different. Just because my response wasn't very durable doesn't mean that your husband's won't be. Here's hoping for the best for both of you!

                    -Bill

                    • August 18, 2017 at 3:46 pm
                    Newmanbell
                    Participant

                      Hi Bill, so when Keytruda does not work, what do they do next for you?  Thank you so much for responding… I love this site.

                      • August 18, 2017 at 7:59 pm
                      mrsaxde
                      Participant

                        Donna, the original plan for me was to receive radiation, and then resume Keytruda. Dr. Sharfman told me there's a "synergy" between radiation and the anti PD1s that they don't fully understand yet. But he said he thought my best option was a trial. So I have been participating in a trial at Johns Hopkins since June. It's a combo of Opdivo and a new med that works on the LAG3 gene. I've been posting about my experience in the trial. I had my first scans since starting just last week and right now they've classified me as "stable disease." There was a 7 percent increase in the total size of the target lesions. While not the best outcome, it's acceptable at the moment. We'll see what the next scans, sometime in late October/early November brings.

                        -Bill

                      • August 18, 2017 at 4:44 pm
                      ed williams
                      Participant

                        Hi Donna, when it comes to Ipi information any thing from James Allison is gold. Here is a link if you are interested to a presentation from Dr. Allison last year. I really like the part about memory in the immune system with t-cells. Best Wishes!!! Ed https://www.youtube.com/watch?v=r1Fp6C1xx6Q

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