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Ask Dr. Chip Your Own Question

Dr. Chip
Dr. Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 27455
Experience:  20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
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Can I spk to a dr

Customer Question

Can I spk to a dr
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. Chip replied 2 years ago.
Hi--what's your question?
Customer: replied 2 years ago.

My father had a ct scan as he had colon cancer surgery in march .

his cea had been rising as

may 3

june 4

july 6

august 8

the scan revealed a 15mm lesion in liver .however we think must be a met.but when he saw his onco, he said we are not sure n want to do a pet scan now .

surely from a ct they can tell if it's a met or not right ?

Expert:  Dr. Chip replied 2 years ago.
Not necessarily Hina--the PET scan will better define it but even then only a biopsy can clearly determine if it's a metastasis or not.
Customer: replied 2 years ago.

But radiologist clearly stayed in the report the appearances r in keeping with disease progression n compared to previous ct there's a new lesion ?

Expert:  Dr. Chip replied 2 years ago.
Well a lesion on ct can have some characteristics of a metastasis but the PET scan would still be a standard of practice before a biopsy was considered
Customer: replied 2 years ago.

But y are they doing a pet rather than a biopsy ? And by looming at scan can they not tell if it's benign or malignant ?

the cea readings I gave you suggest a rise right?

Expert:  Dr. Chip replied 2 years ago.
Yes most likely this is malignant but the PET scan can tell if it's a major tumor by looking at it's blood supply. I know this may not make sense to you but it's done even if a biopsy is being considered
Customer: replied 2 years ago.

They said the lesion was 15 mm on a ct!

My dad does have a history of cysts on liver but a cyst Would be very unlikely right. ?

Expert:  Dr. Chip replied 2 years ago.
It could still be a cyst Hina considering the size--the PET scan would help with determining that
Customer: replied 2 years ago.

What do

u mean by considering the size?

Even mn though rafiologist haa stated - appearances keeping with Disease progression , why did the onco tell my father that thru had a mdt meeting and they are unsure ?

Expert:  Dr. Chip replied 2 years ago.
It isn't all that large. I can't speak directly to what the oncologist is thinking but obviously the ct scan didn't show something that was definitely malignant
Customer: replied 2 years ago.

U may think I'm over worryinv but I thought a ct can show something if malignant

ALSo rafiologist said appearances in line with disease progression but after he said after a unanimous decision they devised to go for a pet as are not sure .

if they could tell it's malignant they would not do a pet right ?

Expert:  Dr. Chip replied 2 years ago.
Yes if the ct showed an obvious malignancy there'd be no need for the PET scan Hina. But really at this point there isn't anything more I can tell you about this
Customer: replied 2 years ago.

Can a ct show an obvious malignancy in liver?

Expert:  Dr. Chip replied 2 years ago.
Again the only true way to tell a malignancy is a biopsy but there are times when what is seen on a ct scan is pretty much a malignancy but this one mass that was seen in his liver isn't obviously malignant.
Customer: replied 2 years ago.

So just from a ct they can tell mostly it's malignant right ?

Expert:  Dr. Chip replied 2 years ago.
In general, yes, some masses on ct look obviously malignant but if it's a round smooth looking mass it's hard to say it is malignant
Customer: replied 2 years ago.

My dad does have a history of liver cysts as the ct last year detected lesions but then MRI confirmed cysts ,

but it as he's had the operation for bowrl

cancer in march this is more likely to be a met right ? The ct scan in April was clear .

plus his cea has been rising as:

may 3

june 4

july 6

august 8

such a rise indicates progression right ?

Expert:  Dr. Chip replied 2 years ago.
In general yes it does but it doesn't absolutely mean a progression. Hina--I've told you everything I can about all this so please let me know how it goes and please remember to rate my service to you
Dr. Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 27455
Experience: 20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
Dr. Chip and 2 other Medical Specialists are ready to help you
Customer: replied 2 years ago.

Hi can I just ask that is there treatment for liver mets?

Expert:  Dr. Chip replied 2 years ago.
Yes--there's surgery depending on the size and location, and there's chemotherapy

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