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PET Scan SUV question

Forums General Melanoma Community PET Scan SUV question

  • Post
    CindyJ
    Participant

      I've read in this forum that a tumor can become bigger before shrinking due to immune system cells attacking during the early stages of immunotheraphy. I'm picturing it as one big blob.

      I'm wondering if anyone has heard from a doctor if that too could explain a crazy SUV number of 17 on an approximate 4cm tumor? …that there's so many cells involved (good and bad) and the battle is why it's so high?

      Or am I just hopeful?

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        cancersnewnormal
        Participant

          I've only had 2 PET's in my 4 years since stage IV… but, one of them did show FDG uptake in an area on my knee, where there was no lesion. It was an immune response from an overly aggressive cycling workout. Sooo… with your question posed, I thought I'd see what I can pull up. There isn't a lot of definitive evidence out there, but I did find this: "As systemic treatments for melanoma have advanced, there has been increasing interest in using FDG avidity not only for staging and monitoring, but as a predictive biomarker to assess prognosis and effectiveness of therapy" —– https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5028983/

          I'm not sure what it would do for the high "glow" number on your lesion… but it does seem that it might indicate your immune system has gone after it. Unfortunately, it seems at this point, that you'll probably have to await the next set of scans, to see if it begins to shrink. I vote for sticking with hopeful. : )

            CindyJ
            Participant

              Thank you SO much Niki! I couldn't find anything at all on this. I mull things over in the middle of the night and this idea came on strong to me. I really appreciate you taking the time to find this article, and I remain hopeful because of it! 🙂

            AliCat61
            Participant

              Hi Cindy. The small tumor that my husband had in his parotid gland got much bigger, very quickly, within a couple of days after his first combo treatment of Yervoy/Opdivo. it doubled in size and extended behind his ear, causing him tremendous pain.  It lasted about 4 days, and then started to shrink, until it was gone. A recent PET scan showed no trace of it. I don't know if that could explain a high SUV or not, but I vote for hopeful!

                CindyJ
                Participant

                  Thank you AliCat! That is very hopeful to me! I think we're going to see if the doctor can keep us on at least two more treatments of the Pembro then do another test, even if we have to pay for it. The more I think about this the more I think we need a specialist. Eight weeks was just not enough time for my mom's first PET after starting treatment. Thanks again!!!

                  CindyJ
                  Participant

                    And I'm so happy for your husband!!!

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