• Any radiologists or other medical pros? How is actual tumor size determined?

    Asked by FreeBird on Saturday, October 20, 2012

    Any radiologists or other medical pros? How is actual tumor size determined?

    As a family caregiver, I read every radiology report. The CT scan reports include a vague description of the tumor, with a linear horizontal and vertical measurement, on what I assume is a visual plane. That seems to me like an insufficient way to determine or describe tumor size. Is there a standard way to determine tumor mass or volume, so that you are sure a tumor is growing or shrinking over time? And why is this measurement not included in radiology reports? Why would there be a descrepancy in what we are told vs. what the radiology reports appear to show as far as size?

    6 Answers from the Community

    6 answers
    • nancyjac's Avatar
      nancyjac

      It is also important to remember that turmors are only vague representations of cancers. Some cancer cells are contained in tumors, some are not. Some cells in tumors are cancerous, others are not. So, in an of itself, even if the measurement of a tumor is entirely accurate, it is not measuring the size of the cancer, only the tumor that most or all of the tumor cells are in. So, to compound the complexity (and usefulness) of measuring tumors, is that they are only a respresentation of the scope of a cancer, and while it may not be the norm, it is certainly possible for a tumor to shrink but a cancer to grow and vice versa.

      over 8 years ago
    • FreeBird's Avatar
      FreeBird

      Thanks for all the good input.

      over 8 years ago
    • FreeBird's Avatar
      FreeBird

      After thinking it through, I think I understand how there can be a difference in what the numbers on a report show, and what they say. That is, that reason comes into play. Because of the infrequency of measurement (expensive scans), you end up with a less accurate picture of what's happening on change-over-time. So you must use reason and the big picture of all the data to create the big fuzzy picture of what's happening in between to fill in the blanks. You can see the tumor numbers go up on a chart at the same time they tell you the tumor has gotten smaller. It is just not smaller since the last time it was measured. Because you measure so infrequently, you have no clue what happens between the points without additional data.

      So let's say you started with a measurement of a 3 centimeter tumor. Months later, you have another CT scan, and they tell you--- Your tumor is 3.8 centimeters. Congratulations. It's shrinking. But you're staring at the radiology report and it's telling you the tumor has gotten bigger, by the measurement. Well let's say you are just getting started, or you get sick and there is a gap between measurement and the time of your next treatment. Based on previous data, and on their experience with tumor growth, they can assume a rate of growth that's going to continue at least until the next treatment. You have gone up from the lower number and down to the higher number.

      The doctor gave me the wrong number at one point, pointing to it in the exam room, and the other number I had didn't look right. It suddenly dawned on me that the other number could be correct for that reason. So it appears that chemotherapy with Gemzar was working for Dad at one point, during the first 3 chemo rounds. With this kind of reasoning, and plotting the additional baseline of zero back to his scan before this year it does appear that the tumor was shrinking after chemotherapy, then started to grow again--- even though every tumor measurement has gone higher.

      over 8 years ago

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