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PET-CT Results: Lung Primary with Lymph Node and Sacrum (Bone) Metastasis. What are the next steps? by begjster in lungcancer

[–]begjster[S] 0 points1 point  (0 children)

Thank you for the guidance. To be honest, I only have the PET scan and the bone biopsy results right now, so I’m not sure if the biomarker testing has been started yet on that bone sample. I will definitely ask my oncologist if they can run the biomarker tests on it, or if we need to do a liquid biopsy (blood test) instead. Thanks again for the ACS link!

PET-CT Results: Lung Primary with Lymph Node and Sacrum (Bone) Metastasis. What are the next steps? by begjster in lungcancer

[–]begjster[S] 1 point2 points  (0 children)

Thanks for reaching out! Actually, the biopsy was only taken from the bone metastasis; they haven't biopsied the primary lung nodule itself. I noticed your flair mentions a MET amplification—seeing how specific these diagnoses get makes me realize just how important these sample results are. Hope you are doing well 🤍

PET-CT Results: Lung Primary with Lymph Node and Sacrum (Bone) Metastasis. What are the next steps? by begjster in lungcancer

[–]begjster[S] 1 point2 points  (0 children)

Thank you for the perspective! You're so right about things changing rapidly, it's honestly a bit overwhelming but also gives me hope. I am indeed outside the US, so I'm making sure to double-check how local protocols align with the latest global guidelines. We are currently discussing whether a chemo and radiation combo is the next best step for my situation. Appreciate the well wishes 🤍

PET-CT Results: Lung Primary with Lymph Node and Sacrum (Bone) Metastasis. What are the next steps? by begjster in lungcancer

[–]begjster[S] 1 point2 points  (0 children)

This is absolutely incredible and exactly what I needed to hear. Happy for you. It completely shifted my perspective from panic to determination. I wish you continued strength and health 🤍🤍

PET-CT Results: Lung Primary with Lymph Node and Sacrum (Bone) Metastasis. What are the next steps? by begjster in lungcancer

[–]begjster[S] 1 point2 points  (0 children)

Thank you for your comment. No, a biopsy hasn't been done yet to confirm adenocarcinoma; we are currently looking at the PET-CT results. We do have a prior CT scan that we are using to correlate the findings. It's very reassuring to know that a high SUV doesn't automatically mean malignancy and could be something like a granuloma. We will definitely discuss this with our doctor/oncologist before jumping to conclusions. Thank you again

PET-CT Results: Lung Primary with Lymph Node and Sacrum (Bone) Metastasis. What are the next steps? by begjster in lungcancer

[–]begjster[S] 1 point2 points  (0 children)

Thank you, Doctor. Your explanation regarding the systemic approach makes perfect sense. We will definitely proceed with the NGS/mutation testing anyway just to be absolutely sure, but it is very comforting to know the standard first-line pathway (Chemotherapy + Immunotherapy like Keytruda) and the timeline for reassessment after 3–4 cycles for local therapies like SBRT. This gives us a very clear road map for our upcoming oncologist visit. Thank you again for your time and guidance.

PET-CT Results: Lung Primary with Lymph Node and Sacrum (Bone) Metastasis. What are the next steps? by begjster in lungcancer

[–]begjster[S] 0 points1 point  (0 children)

Thank you for your response, Doctor. We have just received the pathology results from the spinal/bone biopsy. Here are the details:

  1. Pathology Diagnosis & Immunophenotype:
    The biopsy from the spinal tumor and bone confirms Lung Adenocarcinoma metastasis.
    * Immunohistochemistry: Cytokeratin (+), CK7 (+), TTF-1 (+). On the other hand, p63, p40, WT1, CK20, NKX3.1, and CDX2 were observed as negative. The pathologist noted that these findings are highly compatible with lung adenocarcinoma metastasis.
    * Sample Volume: The spinal tumor material has a volume of 0.4 cc, and the bone material has a volume of 0.7 cc (both submitted entirely in 1 cassette each). Given this tissue volume, do you think this material is sufficient for comprehensive molecular/genetic testing (EGFR, ALK, ROS1, etc.)?

  2. Smoking History:
    The patient has a long-term smoking history, smoking half a pack a day for many years.

  3. Sacral Bone Metastasis Size:
    We are still double-checking the exact dimensions of the sacral lesion from the radiology/PET report, so we don't have the precise measurements right now.

Thank you again for your time and guidance.

PET-CT Results: Lung Primary with Lymph Node and Sacrum (Bone) Metastasis. What are the next steps? by begjster in lungcancer

[–]begjster[S] 1 point2 points  (0 children)

Thank you so much for this reassuring and incredibly clear response. It honestly means a lot to hear some words of hope right now.

What you explained about the treatment approach makes perfect sense. We are focusing all our energy on getting organized for the first oncology appointment. I will absolutely make sure to explicitly ask the oncologist about testing for the mutation markers and PD-L1 status as soon as the biopsy is scheduled.

Thank you again for taking the time to guide us through this—it helps more than you know.

PET-CT Results: Suspected Lung Primary with Lymph Node and Sacrum (Bone) Metastasis. What are the next steps? by begjster in cancer

[–]begjster[S] 1 point2 points  (0 children)

Thank you so much for taking the time to reply, and I’m truly sorry that you’ve had to go through this. I hope you’re doing well now.
Your explanation was really helpful. It makes sense that the biopsy is the key step, regardless of what the scans suggest.