The Thing about Radiologist Reports...

The first time I quit treatments for my stage IV lung cancer was in 2013. I had been getting carboplatin, Avastin and Alimta. My tumors had shrunk by about half during that treatment. However, that regimen made me very ill. When the doctor gave me a 6-week break from it, the tumors regained all of the ground we had gained. That was disheartening, to say the least.

But it is also what pushed me into the clinical trial I started in July 2013 for what turned out to be nivolumab, aka Opdivo. From July 2013 until May 2019, I got regular infusions of Opdivo. In May, due to some potential side effects, including an ugly rash, my oncologist and I decided I should take a break from treatment.

My first scan since treatment ended

In August, I had my first CT scan since treatments ended. To say that I was anxious to get the results of that scan would be an understatement. Were my tumors once more taking advantage of no treatments?

My doctor was out of town, so my nurse practitioner (NP) was seeing me. Unfortunately, the radiologist hadn’t yet read the scan, so the NP and I looked at the slides during the visit. We thought everything looked pretty good, but we both wished for the expert’s report to confirm our assessment.

We learned that the radiologist would be looking at my scan soon, so I just waited on the report to come through. It wasn’t long before we had the preliminary results. Hallelujah! The summary results confirmed our reading of the slides.

Elation replaced with fear

I didn’t take the time to carefully read the report until I got home. There, buried on page two, in the middle of a paragraph, was the following statement: Several bilateral sub-6 mm pulmonary nodules are annotated on the MIP images and 9 definitely changed since the prior exam. (emphasis mine)

What???? My elation at a stable report was quickly replaced with questions and fear. Why in the world was something like that buried in the middle of the report? Why was our attention not drawn to something as significant as 9 nodules “definitely changing” in three months?

Wait and see what my doctor thinks

My first inclination was to call my NP to see if I should return to the clinic. But I knew my doctor was out of town. Until he could read the scans himself, we would take no action, even if NINE nodules had truly changed in size. Also, they were still small (sub-6 mm) so I suspected we would still “wait and see,” though our “wait and see” might mean the next scan would take place in a month or two rather than three.

Since I had already told everyone the scans looked good, I decided not to mention the scary finding until I could at least see the final report. I was praying that sentence was a mistake.

Receiving my updated, final report

At last, several days later, the final report came through on MyChart. When the text message came alerting me to a new test result, you can bet I wasted no time pulling up the report! I quickly scanned the summary results. They still indicated all was well.

Then, I searched for the buried sentence. You can only imagine the relief that flooded through me when I read it on the final report: Several bilateral sub-6 mm pulmonary nodules are annotated on the MIP images and not definitely changed since the prior exam. (emphasis mine)

Errors happen on radiologist reports

The purpose of this article is to let you know that errors happen on radiologist reports! This is definitely not the first time there have been errors on one of mine, though I have to say it was the scariest!