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Dr. Chip
Dr. Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 33690
Experience:  20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
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Why would a radiologist not state the size of a sub pleural Nodule

Customer Question

Why would a radiologist not state the size of a sub pleural
Nodule found as a new finding in a metastic colon cancer pt?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. Chip replied 2 years ago.
Hi--usually the radiologist does measure and report on the size of any nodule like that. If it wasn't on the report it can be added at a later time.
Customer: replied 2 years ago.

He states new sub pleural nodule but no size?

a nodule IS a met right in a colon cancer pt?

Expert:  Dr. Chip replied 2 years ago.
A nodule may be a met but you can't say for sure just with a scan--it would take a biopsy to determine if it's a met from colon cancer
Dr. Chip and 2 other Medical Specialists are ready to help you
Customer: replied 2 years ago.

The thing is assuming thsts a met ( it's under. 1. Cm), there is 1 liver met and 1 lymph node .

so far xeloda and irinotecan

have not worked .

if don't have further chemo and ablate the 3 mets with microwave ablation / nano knife , what is approx survival ?

Customer: replied 2 years ago.





Sent from my iPhone
Customer: replied 2 years ago.





Sent from my iPhone
Expert:  Dr. Chip replied 2 years ago.
That's a different question so you need to rate my service on this page first before we go on
Customer: replied 2 years ago.

If it's not a metastasea, would the rafiologist not put a size on the report ?

Expert:  Dr. Chip replied 2 years ago.
There would be no specific reason for the radiologist not to give the size of the nodule--whether it appeared to be a metastasis or not
Customer: replied 2 years ago.

Is it a good option ablating the three mets ?

Or is chemothearly better ?

Expert:  Dr. Chip replied 2 years ago.
Before we go on can I please ask you a question here? You've asked about this subject--colon cancer and metastases from that and treatement--for a long time on this site and you've talked to several experts. I'm just curious as to what exactly it is you still need to know--haven't you spoken to his doctors about all this?
Customer: replied 2 years ago.

Confussed . Existing onc sdischarged my dad and said nothing we can do as irinotecan did not work .

but got a second opinion as he said he should

have oxyplatin and get these small meta ablated . Don't know what is best

Expert:  Dr. Chip replied 2 years ago.
OK--so what did the second doctor say about his overall prognosis?
Customer: replied 2 years ago.

Well not much he said fight this . But is ablation worth iT or should be we do chemo first ?

Expert:  Dr. Chip replied 2 years ago.
The chemo should be done first. Just ablating metastases really doesn't treat the cancer itself
Customer: replied 2 years ago.

if chemo has not worked on irinotecan , does this mean person is chemo resistant and no chemotherapy would work ?

Expert:  Dr. Chip replied 2 years ago.

Well that isn't an easy question to answer since just because one type of chemo is ineffective it doesn't mean another won't be. But unfortunately at this point I think you need to be told that this is very advanced cancer and his prognosis is not good

Customer: replied 2 years ago.

it's better having 3 small

mets than lots of mets right ?

what would u say in terms of prognosis ?

Expert:  Dr. Chip replied 2 years ago.
Mets are mets regardless of the number or size. If I had to surmise I'd say he probably has no more than one or two years to live but you have to understand I don't have access to his full chart
Customer: replied 2 years ago.

Would this be the case even with ablation and chemo?

Expert:  Dr. Chip replied 2 years ago.
In my opinion, yes
Customer: replied 2 years ago.

Would you recommend to have chemo ?

Expert:  Dr. Chip replied 2 years ago.
If he were a relative of mine I'd say no more chemo
Customer: replied 2 years ago.

Thx a lot for ur view . Would

u advise alternate treatment. ?like

vit c infusions ?

Expert:  Dr. Chip replied 2 years ago.
It's a safe alternative but, truth be told here, it really hasn't been shown to effectively fight cancer.
Customer: replied 2 years ago.

I see . It's a matter of luck even the prognosis right ? some with 10

,2O mets even live years right .we just stuck whether to hve chemo or go with alternate treatment ?

should we ablate the 3 mets whilst they are small ?

Expert:  Dr. Chip replied 2 years ago.
Luck, yes, in a sense. The prognosis is reported statistically but you can't apply statistics exactly to just one patient. I personally see no reason to ablate the mets
Customer: replied 2 years ago.

But won't the liver met atleast b gone and then won't invade the organ and things?

could it be after ablation and chemo no more mets may appear ?

Expert:  Dr. Chip replied 2 years ago.
Well, that's a possible reason for the ablation and it is possible that the chemo will work. At this point though I just can't in good faith tell you I'm hopeful about his prognosis
Customer: replied 2 years ago.

A liver met is dangerous once it gets big right and starts affecting the liver ?

well from august 2014 to jan 2015 the liver met grew by 2mm. Is that slow gowing?

Expert:  Dr. Chip replied 2 years ago.
That's very slow. Yes, a large met could affect the liver
Customer: replied 2 years ago.

Last query sorry , what actually kills a person from the cancer ? Is it the cancer invading the organs etc ?

thats we thinking get the liver met ablated

Expert:  Dr. Chip replied 2 years ago.
Yes, it's usually the mets that eventually kill the cancer patient.