Cancer

[george_349]

I was diagnosed with colon cancer 8 years ago and they removed 19 inches of my colon at that time.  Now, I had a PET scan done a few weeks ago and a spot (size of a lima) bean was found.  I was sent to an orthopaedic doctor and he has discussed the scans with 4 radiologist and they will not commit 100% it is not cancer. So, now they ahve requested a CT/biopsy after a consultation with an Interventional radiologist next week.  Do you feel this could be cancer?  What I have read colon cancer spreads to the liver and also my lab work showed OK an every test.

[Fernando Roque, MD]

Hi.  I just need to clarify something: you said your husband had a lung operation for cancer 3 years ago.  What kind of cancer did he have back then? Did it originate from the lungs itself or did the cancer come from somewhere else and subsequently spread to the lungs?  If your husband's cancer originated from the lungs, I cannot understand why your doctors had to order CEA (carcinoembryonic antigen).  This is a tumor marker which is probably useful for detecting colorectal cancer recurrence, but is not very specific or sensitive for detecting lung cancer recurrence.  Given your husband's previous background of cancer, his persistent neck pains should be checked for any possibility of metastatic spread to the cervical spine.  I would have done a bone scan right away and not wait for CEA results to come out (if this is lung cancer recurrence, the CEA is not a good test for it anyway).  In addition to the bone scan, I would also try to check other areas of the body (e.g. liver and adrenal glands) which lung cancer has a propensity to spread to.  This can be done by doing a CT of these areas.

[Miri775]

My Husband had a lung removed to cancer 3 years ago...since Sept he has been having neck pains, and was diagnosed with cervical spondylosis (excuse the spelling) he has had PT, MRI  CT scan which confirmed what the doctors said, however his blood work up came  back with a CEA of 25, so they are going to redo the taste, then check for bone cancer if his CEA is still high.   I am so scared and sorry for him, does that sound like they are on the right track?

[Fernando Roque, MD]

Hi.  You're right. Colon cancer does not usually spread to the femur/hip areas, but such an occurrence is not impossible.  Although that bean sized spot is not likely metastatic spread from a colon cancer, I think that proceeding with the biopsy is still the right thing to do.  In your case, I think it's better to err on the side of caution.  If the biopsy results turn out negative for cancer, then well and good.  

[george_349]

I am sorry that I did not indicate the location of the spot, but it is located between the femur and hip which is the reason they sent me to an orthopaedic doctor.  My PET scan showed that the liver and stomach area was OK, but the radiologist saw this spot and have requested the biopsy.  The CEA  test was normal. Everyone tells me that is is very rare the cancer could have spread to that area. Is this correct? Thanks, george_349

[Fernando Roque, MD]

Hi.  You did not state it explicitly in your post, but am I correct to assume that the bean sized spot was found in your liver?  If it is, your doctors are doing the right decision in having that biopsied.  Colon cancer has a propensity for recurring in the liver, and even though your cancer was first diagnosed eight years ago, colon cancer has been known to  come back as late as 10 years from initial discovery. So there is still a possibility that the lesion could be cancer, but we can't know for sure until a biopsy is done.  By the way, has a CEA (carcinoembryonic antigen) test been done? If so, what are the results? This blood test is a tumor marker which can help confirm a diagnosis of recurrence.