I always seem to be questioning the steps my dh's doctor is taking when I post here. Thanks for your patience in reading yet another question from me. :)

to recap - After surgical removal of a tumor in his colon (stage 2), dh followed up with an oncologist, who told him that he believed the surgery was curative. I asked how the doctor could be certain, since no CT scan or x-rays were done (or CEA tests) at any point in the process of diagnosing and treating. The doctor consulted his notes and found this to be true. He ordered a CT scan and CEA testing.

The initial CT scan came back showing a small spot on dh's liver. CEA testing revealed a score of 4.6. DH chose not to know the results of his test. (A whole other story...) As far as he knows, the CT scan he had done again last week (of his abdomen and pelvis) was just a regular follow-up to the initial scan ordered by the dr..

We go back on Wednesday to see what this scan and new bloodwork reveal. I'm hopeful it was just an anomoly caused by his surgery - a pocket of blood, or scarring...

My question today, though, is this - if the first places CC usually spreads are the liver and lungs, and he's never had an xray or CT of his chest, how can we be sure there are no mets there?

I suggested DH get a second opinion when he was first diagnosed and deciding about surgery and treament, and he blew me off. I guess I'm afraid that a clear scan of his liver (God willing) will be taken as a sign that there is NED, when the lungs have not been examined at all.

Are my concerns making sense, or am I just losing it here? (Which is entirely possible, I admit.)

Yes you are making a lot f sence. My DH had LC and every three months he has scans even though the surgery was a sucess. He will have scans every 3 months for two years and then every 6 mos for years then once a year forever. My cousin's husband had colon and stomach cancer he went to Sloan and his surgery was a sucess no chemo after (my dh had Chemo as a just in case measure)and no PET scans or CT scans as a follow up not even an X ray.Three years later he has LC.My husbands ONC as does most believe in follow ups just because the nature of cancer. Be your husbands advocate.
My Prayers are with you and your husband

If I were you, I would mention the chest x-ray to the doctor when you go on Wednesday. My husband had one when he was first diagnosed and then a year later. He also had one last year before he had cataract surgery so we know he should be ok in that area at least.

Hopefully, the spot on the liver is just a cyst or something like that. My husband had two show up on a ct scan after treatment. I also have two on my liver, which showed up on my ct scan, at which time they found lymphoma in my abdmen. It seems that liver cysts are quite common, especially in my family!!

Let us know how it goes on Wednesday.

Love and prayers,

Hi, pearl
That is true that colon cancer usualy spreads to the liver first, and than lungs. But in some cases it can give mets to the lungs skipping liver(rare). The standard CT protocol for colon cancer even without known mets in the liver is CHEST, ABDOMEN, PELVIS.
mikosha

I appreciate your responses.

I'm going to ask the doctor on Wednesday about some sort of chest exam, whether it is xrays or CT scans. I'm not sure whether chest studies were never ordered or whether they were denied by our previous insurance company. Thankfully, we changed insurance companies in January (I hope for the better).

A CAT scan is better than a chest x-ray for detecting small lung nodules since it sees them before they would show on an x-ray. As a matter of fact, yearly chest CAT scans have been recommended for smokers at risk for lung cancer as a small cancerous growth that can be cured by surgery would be detected by a CAT but not seen until it is much further along in its growth on a chest x-ray, possibly beyond the curative stage or much more difficult to treat. Wedge resections of the lung and RFA to growths in the lungs are potentially curative if a met is discovered while still small. Insist on your husband getting a CAT scan of the chest. This will serve as a baseline to compare against and the CAT should be repeated in three months if anything suspicious shows, or in six months if clear and then yearly for several years.
On another Board I frequent there are persons who have had solitary lung mets appear several years after colon surgery and were discovered via routine periodic chest CAT scan and successfully resected.
Leslietoo

I agree, ask for a ct of the chest, abdomen & pelvis. This is how my dh's oncologist always has it done. Dh had a chest x-ray and ct in November and the ct showed a small spot on his lung. He had another one in January and it showes 3 small ones now. So the ct of his lungs definately need to be done. Good luck.:) dee

Good news! The spot on his liver was a cyst and his CEA count dropped. The doctor said he wouldn't need any more scans, just blood work every three months. After getting advice from this board, though, I questioned that, politely ;) , and he said, in essence, "If it will make you feel better, we'll do a scan in 3 months".

I like this doctor - he has a nice personality - but I don't feel he's as aggressive in treatment as I wish he'd be. It's not my call, though; it's my husband's.

I appreciate being able to come on this forum and get advice and encouragement from people who have "been there". It means a lot. Thank you.

I forgot to add - I learned that dh did have a chest CT when the initial tests were done, and it was clear. The insurance company denied the chest scan for last week's test, but I'm hoping our new insurance won't give us problem when he's due again for CT scans.