Tracking PSCC - CT
We are tracking PSCC using CT scans. We have seen the PSCC get to the left lung (left lobe) and a nearby lymph node. This new CT seems to suggest all the PSCC in the lung has been resected. At the same time, the report puts a cautionary focus on the hilar nodes in the central area of each love. Small changes are noted, but these changes are “indeterminate” meaning the CT is not returning enough information to say this is inflammation or metastasis of PSCC. This points to the need for very close attention to this area, through Signatera assays and frequent imaging. I will develop questions from this report for the Thoracic Surgeon and my Oncologist.
The encouraging part of this CT report is not just what was seen—but what was not seen. The report states there is “no convincing evidence of residual or recurrent neoplasm” along the surgical margin where the left lower lobe metastasis was removed. There are also no new suspicious lung nodules or masses, and no evidence of disease below the thoracic region. Big picture, that matters. After everything that has happened over the past year, I do not take that lightly for even a second. My “bits down there” remain safe for now, which is very good news. Reading through this report, I do not see giant red warning flags suddenly going up flag poles. I see a scan that is cautious, watchful, and focused on continued surveillance rather than immediate alarm.
The biggest unresolved question in this scan involves the left hilar lymph nodes. These are lymph nodes located near the central structures of the lung where the bronchi and major blood vessels enter. The report describes them as “mildly enlarged” and “indeterminate”, meaning the radiologist cannot confidently say whether the changes are simply reactive from surgery and healing, or whether they could represent nodal metastatic disease. One reassuring detail is that these nodes did not show FDG uptake on the recent PET scan, which lowers concern but does not completely eliminate it. What I take away from this is focus. The radiologist is essentially saying: watch the hilar nodes closely. There was a small increase in size noted, but that increase could come from post-surgical inflammation just as easily as cancer activity. For now, the lungs remain the new focal area—careful observation, close imaging surveillance, and continued attention to what happens next. I am reassured I have Signatera assays as a new and import part of my surveillance tools. My journey continues. I wish you strength and peace in your journey. Keep asking questions and advocating.