Experience I'm a Doctor of Medicine. Licensed/certified physician and surgeon and specialist in Medical
Oncology and Radiation therapy in Sweden, Denmark, Finland, Iceland, Norway and the European Union. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine.
M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps. Now in private practice in Stockholm, Sweden.
I also answer questions in these other categories: General History,
Military History,
Brain Tumors,
Breast Cancer,
Colon Cancer
Question QUESTION: Hello. I am in remission for Mediastinal B cell lymphoma (Stage IIB). I received 6 cycles of R-chop, followed by mediastinal radiation. completed radiation in august 07. I had my first negative PET in Oct 07. My two most recent CT scans show (october and march) that the scar ball that was my tumor has shrunk both times. On my next onc visit, I know that my doc is going to recommend a PET scan. I am aware of the guidelines for PET scans that came out in Jan or feb 07, but there seems to be no mention of protocol for patients who are in remission. I am concerned about the toxicity of the scan (trying to get pregnant), and i don't see clear research on the use of PET for someonelike me who is doing well. I know that you can't make the call for me. If there is any researh on the subjet, i would be interested in referencing it. My doctor told me that the cancer cells can grow within the scar even if it does not get bigger,which is why I need the scan. Dr Portlock at sloan kettering told me that i don't need a PET unless the scar ball grows. My doc disagrees with this. any input that you may have would be appreciated. i realize that you don't know my case, but i would like any info that I can reference for when i see my doc. thank you very much
ANSWER: Let me put it this way. While I have the deepest respect for Sloane Kettering Memorial I still agree with your dr. in order to be on the safe side. There is a lower limit to the sensitivity of a PET scan. Still it can see an increase in metabolism (which is what it does) BEFORE any growth of your scar ball can be seen with any certainty! That is just a deduction based on how these different investigative methods work and your present situation. You have a somewhat exaggerated view of the toxicity of a PET scan. I think in this situation a pregnancy can wait until this has been tested. So I strongly suggest that you follow the advice of your dr.
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QUESTION: Thank you for your answer. I will get the scan. At what point can I stop getting scans?? Do you consider 2 years a cure for my type of lymphoma?? do you see relapses past 1 year??
Answer You are most welcome! Unfortunately not for many years to come. After 5 years you can relax mostly (but probably never 100%). So 2 years is not a period of time I can promise a cure in. There are many types of B-cell lymphomas. Some are relatively well behaved while others are not. Some of the well behaved may be cured if not relapsing in a period of 2 years, but since I have no certain knowledge of what type your B cell lymphoma was I can not offer any guarantees unfortunately. I think you should consider this when thinking of any pregnancy. Yes you do see relapses past 1 year! I'm sorry I can not promise you anything!
Maybe your oncologist who should know much more about your lymphoma can tell you more.
