If My X Ray or Scan Still Has Spots on It, or Some of My Blood Tests Are Not Normal, How Can the Doctors Say I Am in Remission?

It is very possible for your X rays, scans, or blood tests to remain abnormal even though no evidence of cancer is detected. X rays and scans can remain abnormal because the treatments got rid of all the cancer cells but left a scar in the area. This situation is similar to that of a skin infection that is cured with antibiotics but heals with a permanent visible scar, or that of a pneumonia that resolves but leaves a permanent spot on your chest X ray. Blood tests can remain abnormal, reflecting the changes that occur as your body recovers from the treatment.

How Do Doctors Know Which Spots Are Cancer and Which Are Scars?

Your doctors can usually know whether a spot on an X ray or scan represents a scar or leftover cancer on the basis of

• subtle differences between the appearances of scars and cancer

• the different behaviors over time of scars and cancer

When there is any doubt, and the answer will affect decisions that need to be made at this time, the only way to be sure whether a spot is cancer is to biopsy the spot.

How Do Doctors Know Whether an Abnormal Result on a Blood Test Is Due to Cancer?

Your blood test results are interpreted with regard to all the other available information about your specific circumstances. For example, if you develop elevated liver enzymes in your blood, this does not suggest cancer if your type of cancer rarely spreads to the liver and if your treatment is expected to cause such an elevation.

Sometimes your blood tests will indicate abnormalities that cannot be explained completely. If the results of your physical exam and various scans do not explain the abnormality, your doctor may have to watch and wait to determine the significance of the blood test abnormality.

It is not uncommon to have unexplained abnormalities that persist for a while, or indefinitely, following cancer treatment. These abnormalities often have no impact on people’s lives or their prognoses. The surviving of cancer may mean living with «blips and spots» on tests.


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