that is the area surrounding the aorta (the largest artery draining blood from the heart to the lower body) and inferior vena cava (the biggest vein draining blood from the lower part of the body back to the heart)
there are lymph nodes all throughout that area so i'm assuming you're wondering about aortocaval lymph nodes?
basically there are lymphatic structures and fat in that area
Well my dad had colon surgery kn march and a tumor was removed . He was a dukes c1. A recent scan shows 1 aortocaval node met of 10 mm. I was lnt sure where this area was and whether 10 mm node is large ?
They have started irinotecan alone , can this be effective in treating this ( eg can it get rid of it)?
1mm is exactly at the limit of what a "normal" lymph node could be. It is a large enough lymph node that if it were pathologically enlarged (i.e. metastatic disease) that it should show up on a PET scan.
they have to be about 7mm or larger to be reliably seen on pet scans if they are enlarged due to metastatic disease
and theres 1 liver met of 16 mm with uptake of 5.2,
so I'd recommend a PET-CT
that is significant enough to be considered a met, yes. Did the lymph node show positive?
if it didn't show significantly above background that doesn't mean that it is not a metastasis in development
Thy say on a pet scan it did .
Then yes it would most likely be caused by a metastasis
in that lymph node
Can the chemo treat the 2 mets?
I was wondering y they cannot remove / ablate them
yes it would treat all metastases throughout the body. Some may respond better than others but that can only be determined with a repeat PET after treatment
To be 2 at present so I was wondering as the cea is 9
Cea has not come down and he's had 4 sessions of irinotecan
August was 9.8, sept was 8 for some reason and December 9.
What would prognosis be like for such a situation ?
that is elevated and if he still is having PET-positive metastases and he has been under 4 rounds of chemotherapy perhaps the oncologist will investigate either a new medication and/or method of drug delivery such as transarterial chemoembolization or percutaneous (through the skin) ablative techniques such as radiofrequency or microwave ablation.
If there is a lesion which has no
yes that's what we want ablative techniques or surgery but they only doing chemo
chemo can be used in tandem with the other techniques
and often are synergistic - in other words when used together they provide better improvement in disease progression
these are performed by interventional radiologists (you need a referral by the oncologis)
Did I answer your question?
Oh I see
So we need to push for something along with chemo right nt just chemo ?
Is irinotecan effective ?
yes but one chemotherapy does not fit all patients
Is it as there's a node there they can only do vhemo
adjunctive therapy such as percutaneous ablation or chemo-embo would be the next option in my opinion
yes only chemo for a node
So nothing can
So nothing can work on the node ?
external beam radiation can target nodes even in conjunction with chemotherapy, however that would need to be discussed with his oncologist
whether they feel it is a viable option.
If kept under control can survival rate be good? Are we talking less than 5 yrs ?
All they saying is chemo
So I need a second opinion as ppl
if hepatic metastases are kept under control and do not cause any biliary obstructive problems or overt liver failure then yes a 5 year survival is not impossible
As with 2 mets I find it hard to believe they can't do much
but that is speaking in general
i would suggest seeking consultation with an interventional radiologist through his oncologist to discuss adjunctive therapies
yttrium-90 radioembo, chemoembo, bland embo, or percutaneous ablative therapies would all potentially be options
Yes will do that then ASAP . So it's not like at present the patient haa like 1-2 Years only ?
No. You can't say that as a blanket statement.
U have been very helpfull thank you very much .
Glad to have helped!