What is the likelihood of a pulmonary nodule shrinking in two months?

[cgpd4376]

My sister-in-law (52-years old) was diagnosed with stage three colon and rectal cancer in July. She began chemotherapy in mid-August and finished last week.  In October, her first CT scan since undergoing chemo, showed significant tumor shrinkage.  The scan she had this week still showed success with shrinkage; however, two other disconcerting things appeared.  She has a spot on her liver that was not there two months ago.  Both the radiologist and oncologist believe that it is not cancerous, as it doesn't have the characteristics of cancer, and said that a new cancer would not grow while someone is undergoing chemo. They also told her that the nodule that is in her lung has shrunk.  However, they never even told her previously that she had a nodule!  They didn't say how large it was, whether it could be cancer, etc.  So, I'm wondering, given the fact that the nodule has shrunk (I don't know how much.), is it likely that the nodule is responding to chemotherapy, and therefore likely malignant? Or, is it possible the nodule was due to lymph nodes, infection, etc. and has shrunk on its own?  The oncologist has not said anything, other than next month they will proceed with radiation and oral chemo as planned, and then do another scan in two months to see how both the liver spot and nodules compare in size to the scan this week.  He didn't mention doing a biopsy, PET scan, etc., so I'm not sure if he's not concerned about the nodule being cancerous, if it's too small to biopsy / get an accurate PET scan result, etc.  Does anyone have any knowledge on this topic?  The oncologist told her in August that her cancer is completely treatable and it was only in one lymph node...but now we are left to wonder for at least a couple of months, if her prognosis is still pretty good, or if the staging was incorrect and she's actually terminal.  Any feedback is greatly appreciated!

[Paxiled]

No special knowledge, but no doctor can really tell you if cancer is terminal or not unless it's been around for a long time and the person is clearly dying.  Cancer can be a disease people can live with a long time before it kills someone, or it can be quick, but I doubt docs can necessarily tell.  Some people are very strong and others aren't.  I lived with this with my Mom, who was left paralyzed before the docs even could confirm she had cancer despite a couple biopsies (this was a long time ago, so they're much much better at it now) but she lived 7 years pretty much stable until suddenly she wasn't stable anymore.  Which means, for peace of mind, always be optimistic because you might as well be optimistic, the human body is very hard to predict.  That being said, if you do have concerns, you'll need to press your oncologist most likely because specialists in general and especially surgeons are not very communicative as a rule so again, if you think there's more to know press it until you get answers from the doc.

[Paxiled]

Didn't mean to sound like cancer is always terminal -- these days there are tons of people who have survived it.  I just wanted to say that these things are very hard to predict because different people react very differently, and so yes, some folks get an incredibly good and quick response.  

[cgpd4376]

Oh, no, I didn't take it that way.  And I guess rather than using the word "terminal" I should have said stage four.  It's just that stage three still has a relatively good prognosis, but stage four generally means death is imminent, probably in the next five or so years.  I'm sorry to hear about your mom; cancer is the worst.  I lost my dad to lung cancer nearly 12 years ago and it's the worst thing in the world to watch someone you love deteriorate and be in so much pain.  My sister-in-law and brother are both nurses, so at a bit of a loss as to why they haven't asked these questions, but perhaps when they were there, they were still processing.  I just know that I'd not be able to stand going a couple of months wondering whether I could be living or dying so I can only imagine what they're going through, and you're right, nobody has been very communicative.  

[Paxiled]

Again, no special knowledge, but four or five years isn't imminent.  Imminent is very soon.  The problem with human life is you'll never really know you're dying until you die, and then of course you don't know it because you died.  You kind of know especially if you're very old, but that's not the case here.  To quote a cliche, we all start dying the day we're born, it's just a question of when, and we really can't know that.  Neither do doctors, though they do have a much better idea than we do.  I wish life weren't like this, it's awful, but it is.  Your best option here is still to talk to the docs who are treating her until you get the answers you need, but be prepared to just not know and again, be optimistic since when you don't know you might has well hope for the best.  Peace.