9mm lung nodule and lytic rib lesion

Portal Forums Lung/Thoracic Cancer Work-Up/Staging of Lung Cancer 9mm lung nodule and lytic rib lesion

This topic contains 99 replies, has 6 voices, and was last updated by  Cheryl3700 1 month, 3 weeks ago.

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September 15, 2015 at 12:07 pm  #1271168    

Cheryl3700

Can’t figure out how to get the signature with history on my ID, any link to how to do that?

September 15, 2015 at 1:26 pm  #1271169    
catdander forum moderator
catdander forum moderator

Hi Cheryl, this link should help, http://cancergrace.org/topic/grace-tips-set-your-forum-signature

Note that there are 2 profiles, one for WordPress our host site and one for Grace. Your want the Grace profile and can get there by clicking on your user name, “Cheryl3700″ to the left of your posts.

Hope this helps,
Janine


My husband, 8/09 53 @ dx stage III squam nsclc R. pancoast tumor
Destruction of 3 ribs, touching brachial plexus.
6/09-8/09 2 core and 1 VATS undx biopsies. Open thoracotomy for 1 positive biopsy (unresectable)
9/09 Chemo/rads curative intent
11/09 MRI by pancoast specialist surgeon spine met found undiagnosed Rad to spine, Chemo continued thru 6 cycles
Tarceva maintenance 2/10
11/10 3cm tumor L lung, undx core bx w/collapsed lung. Gemzar, 12/10 through 7/12
NED 3/12, stop tx 7/12. Remains NED as of 9/16
Unanswerable question. Was it ever metastatic?

October 16, 2015 at 10:44 pm  #1271499    

Cheryl3700

Update after 12 rounds of folfox, ct scans on Oct 11 15 showed everything previously noted is stable. But it did note a new finding:

There is new patchy ground glass opacity in the posterior aspect of the right upper lobe maybe represent a focal area of infection or aspiration.

Wish they would have mentioned the size of this new area. Waiting to get ct images and try to find it.

But since all else is stable, going onward for chemo 13-16.

October 17, 2015 at 8:48 am  #1271502    
JimC Forum Moderator
JimC Forum Moderator

Hi Cheryl,

Congratulations on another stable scan report! Infection/aspiration seems like a pretty likely explanation for the patchy area, and I hope that turns out to be what it is.

Thanks for sharing your good news!

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

December 9, 2015 at 1:54 pm  #1272096    

Cheryl3700

Update Dec-9-15: Completed 16 rounds of folfox with 5-fu pump. Waiting re-staging scans fri Dec-11.

Hubby was having severe issues with dexa, rage and extreme agitation episodes. He was taken off the dexa for chemo #15 and it is the first time he got sick, developed horrible chills on way home from hospital and was throwing up in the car, had fevers for 3 days. So for chemo #16, the dr thought lets chance it again, maybe coincidentally he had some bug during the prior session.

So chemo #16 starts and before the oxiliplatin is done infusing, he starts with the same horrible teeth chattering chills, they stopped the bag. He said he was not nauseous just chilly. They hooked up 5-fu pump and we tried to go home. In lobby of hosp he got real sick again. He looked so weak, that I put him in a wheel chair and brought him back upstairs to infusion center. In there he passed out and they did an EKG, after which he passed out again with seizure like movements of head and arm, they stopped 5-fu and went into emergency mode. After many many tests, all looked ok, they assume hes now become allergic to the chemo.

Going to allergy testing Dec 16. He’s very weak still even 1 week after all this. Worried.

December 10, 2015 at 11:03 am  #1272138    
catdander forum moderator
catdander forum moderator

Hi Cheryl, I’m so sorry about the difficult time your husband is having. I know how worried you must be. Hypersensitivity to a platinum drug is very common past 4 or so cycles. We have a lot written about it so you can do a search but the usual thing to do is stop the platinum and continue with the other drug. This is a good example of the threads about it, http://cancergrace.org/lung/topic/carboplatin-hypersensitivity-reaction/

I hope hope hope your husband feels better already.

Janine


My husband, 8/09 53 @ dx stage III squam nsclc R. pancoast tumor
Destruction of 3 ribs, touching brachial plexus.
6/09-8/09 2 core and 1 VATS undx biopsies. Open thoracotomy for 1 positive biopsy (unresectable)
9/09 Chemo/rads curative intent
11/09 MRI by pancoast specialist surgeon spine met found undiagnosed Rad to spine, Chemo continued thru 6 cycles
Tarceva maintenance 2/10
11/10 3cm tumor L lung, undx core bx w/collapsed lung. Gemzar, 12/10 through 7/12
NED 3/12, stop tx 7/12. Remains NED as of 9/16
Unanswerable question. Was it ever metastatic?

December 10, 2015 at 11:28 am  #1272139    

Cheryl3700

Janine, thanks for the response. Was thinking hubby made it thru 14 cycles with dexa without issue. Its too coincidental that the 2 where dexa was skipped, he had issues. In any event, he will be allergy tested to see if skin test is positive. His Esophageal Cancer is being kept at bay, but not shrinking, so I’m not sure what next steps will be. I believe they are talking to use the desensitize option, they don’t want to stop this drug before they absolutely need to. Will update in a few weeks.

December 13, 2015 at 4:44 am  #1272192    

Cheryl3700

Ok got ct scan results. I’ve spent some time comparing to last 5 sets of scans. I’m nervous that things look ever so slightly progressed.

But what is strange, I see something new that was not on any prior scans all the way back to last Feb. It’s in bottom of left lung and its shaped like a mini tornado, very long stringy thin part going to a thicker base. I’d say 6mm at widest, and perhaps as long as 19mm. It’s not white, it’s got same looks as other soft tissue looks in that area. Are tumors always round?

Waiting is the hardest part, won’t see onc til Dec 18th. Hopefully it’s something else weird showing up.

December 13, 2015 at 8:07 am  #1272194    
JimC Forum Moderator
JimC Forum Moderator

Hi Cheryl,

With regard to the existing nodules, if you see “ever so slight” progression, I would caution against reading too much into that. Depending on the way the CT “slices” are cut, nodules can look slightly different without indicating true progression. And if it’s that hard to spot, it’s most likely not clinically significant.

As far as the other anomaly you describe, you may want to discuss that with your doctor, as it’s hard to know what it could be without seeing the images. If it appears on only one image, it could be a digital artifact not representative of anything.

Although I was guilty of the same thing, this may be a good example of the dangers of reading your scans, or even trying to interpret radiologist’s reports. There were times when I was concerned about something seen on an image or mentioned in a report, which when discussed with my wife’s oncologist it turned out to be insignificant.

I hope that’s the case for you.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

December 13, 2015 at 3:14 pm  #1272195    

Cheryl3700

Thanks so much for the response Jim, yes, I understand that I may not have the same slice on current CT matching properly with same slice on previous CT. I’ve looked at every set up to now and I was correct there was no progression in the last 4 scans. This new item shows up in many slides for the length of it, in the 1.00 slices it shows up in about 19 slides, it was not in any of those last 5 scans. It did not exist in any view before axil or sag or cor. But its in all of them for this set. He did have the issue of a seizure and they took a chest xray 2 weeks ago and at that time, it noted reduced lung volume then, who knows maybe it’s a side effect of the episode and will go away. Thanks again for your response. Cheryl

December 16, 2015 at 2:41 pm  #1272224    

Cheryl3700

Skin testing was negative for oxiliplatin, but Dr says negative doesn’t mean not allergic, just means skin testing didn’t cause a reaction.

I see this on ct scan report online: Tiny hepatic hypodensity too small to definitively characterize but somewhat concerning as it is new or more conspicuous than prior. Esophagus and rib unchanged.

Found chest X-ray report which states the following: Patchy opacities appreciated at the left lung base, may represent atelectasis, aspiration or pneumonia. This is what I’m seeing in lung.

Still waiting for chest ct report.

Meeting with Onc Fri to see how we will proceed.

December 17, 2015 at 9:31 am  #1272228    

Cheryl3700

CT chest report: There are new nodules in the left lower lobe, along the right major fissure and in the left lung base measuring up to 4 mm. Impression: Indeterminate new lung nodules. The possibilities include inflamatory nodules and metastases.

Are new nodules a sign chemo has failed? Time for trying new chemo?

December 17, 2015 at 12:08 pm  #1272230    
catdander forum moderator
catdander forum moderator

Cheryl,

I’m so sorry there is possible progression. I think you know this but want to make sure that you know we don’t have any specific information on esophageal cancer so we don’t have info on these particular drugs. When speaking about chemo usually it works for a while then not as much or the side effects become too harmful. The signs of growth where it had once contained or shrunk tumors are usually signs of a chemo not working as well as it once was. New growth points to treatment not working though sometimes size matters. I’m not familiar with the drugs he’s taking and couldn’t say where on the spectrum all this lies. A call into the cancer center to speak to a nurse or doc is very appropriate for questions you have.

The overall point of treating any incurable cancer is to lengthen life while also maintaining quality of life. These are the 2 goals all treatments should be based on. I’ve always found the idea of maintaining the balance a most daunting part of oncology.

I hope you, your husband and his treatment team maintain a good balance for a long time to come.

Thinking of you,
Janine


My husband, 8/09 53 @ dx stage III squam nsclc R. pancoast tumor
Destruction of 3 ribs, touching brachial plexus.
6/09-8/09 2 core and 1 VATS undx biopsies. Open thoracotomy for 1 positive biopsy (unresectable)
9/09 Chemo/rads curative intent
11/09 MRI by pancoast specialist surgeon spine met found undiagnosed Rad to spine, Chemo continued thru 6 cycles
Tarceva maintenance 2/10
11/10 3cm tumor L lung, undx core bx w/collapsed lung. Gemzar, 12/10 through 7/12
NED 3/12, stop tx 7/12. Remains NED as of 9/16
Unanswerable question. Was it ever metastatic?

December 18, 2015 at 1:51 pm  #1272236    

Cheryl3700

Met with Onc today, since all new findings are tiny and known cancer locations are unchanged, we will continue with folfox until absolutely necessary to move off it. Plan is inpatient desensitizing infusion for next round, awaiting date from hospital.

Meanwhile on NBC nightly news last night was a segment on EC. Getting word out there, new cases are growing at alarming rate.

December 19, 2015 at 12:01 pm  #1272244    
catdander forum moderator
catdander forum moderator

It’s good to hear he can remain on same chemo. I heard of others getting desensitization treatment for chemo that works well but has acquired hypersensitivity. I hope he does very well and the small spots are nothing more than a fleeting infection already gone.

Best of hopes moving forward,
Janine


My husband, 8/09 53 @ dx stage III squam nsclc R. pancoast tumor
Destruction of 3 ribs, touching brachial plexus.
6/09-8/09 2 core and 1 VATS undx biopsies. Open thoracotomy for 1 positive biopsy (unresectable)
9/09 Chemo/rads curative intent
11/09 MRI by pancoast specialist surgeon spine met found undiagnosed Rad to spine, Chemo continued thru 6 cycles
Tarceva maintenance 2/10
11/10 3cm tumor L lung, undx core bx w/collapsed lung. Gemzar, 12/10 through 7/12
NED 3/12, stop tx 7/12. Remains NED as of 9/16
Unanswerable question. Was it ever metastatic?

January 28, 2016 at 4:21 pm  #1272771    

Cheryl3700

Chemo sessions #17,18,19 folfox
Drs are thinking oxiliplatin allergy, did inpatient desensitizing folfox, added back steroid (prednisone). Bad agitation attacks came back, had 2 just now.

Last scans in Dec 2015 showed new lung nodules and new concerning spot in liver. Since all are new and tiny, waiting for next scans after #20.

Hubby getting tired of it all. I just don’t know how to help him.

Thanks for reading.

  • This reply was modified 1 year, 3 months ago by  Cheryl3700.
  • This reply was modified 1 year, 3 months ago by  Cheryl3700.
January 28, 2016 at 9:48 pm  #1272779    
catdander forum moderator
catdander forum moderator

I’m so sorry your husband has to go through all this. Stopping treatment is always a option. There may be a trial or other treatment to try. There will be a time at which no treatment is better than bad treatment. I think the hardest treatment decision is to choose to stop treatment and move to comfort care only. I think it’s the most important one too. A break with a plan to start again in 2 weeks or a month is also possible. He can always go back. He could stop treatment, go on hospice (comfort care) then decide to go back to anti cancer treatment.

An important note is there are excellent studies done that show people with incurable cancer who stop treatment when more harm than good is being done with live longer and happier lives with hospice care.

Since my husband is NED since 3 years I never had to be in the situation to have an opinion on that. Please don’t think I’m suggesting that hospice is the what I think you should do. I just want to make sure you have that side of the options list.

I hope he’s feeling better soon and I hope you are getting some of what you need as well.
Janine


My husband, 8/09 53 @ dx stage III squam nsclc R. pancoast tumor
Destruction of 3 ribs, touching brachial plexus.
6/09-8/09 2 core and 1 VATS undx biopsies. Open thoracotomy for 1 positive biopsy (unresectable)
9/09 Chemo/rads curative intent
11/09 MRI by pancoast specialist surgeon spine met found undiagnosed Rad to spine, Chemo continued thru 6 cycles
Tarceva maintenance 2/10
11/10 3cm tumor L lung, undx core bx w/collapsed lung. Gemzar, 12/10 through 7/12
NED 3/12, stop tx 7/12. Remains NED as of 9/16
Unanswerable question. Was it ever metastatic?

January 29, 2016 at 7:19 am  #1272787    

Cheryl3700

Thanks Janine, hubby always feels like its time to stop when he’s having one of these attacks. But afterwards his mind is set to continue and fight it with more Chemo. He’s usually nervous to report any side effects because he’s afraid they will stop this first line of folfox. But then again in the throws of bad reactions, he’s saying he wants to stop. It’s such a double edge sword. On one hand he knows the treatments have given him these past 10 months with relatively no issues from his esophageal cancer, just dealing with chemo side effects. On the other hand he just waiting for the other shoe to drop and for the folfox to stop working and that’s got him really on edge. When my Mom had terminal cancer back in 2011, it was such a different experience, she was accepting and happy go lucky. I’m still struggling that he’s struggling so bad. So tough. Cancer sucks.

January 29, 2016 at 10:34 am  #1272789    

Cheryl3700

I’ve been charting hubbys ALC, AMC, NLR, PLR & ANC since last April. Recently for the last 2 blood works done before chemo, his:
PLR has doubled from around 100, to now around 200
NLR shot up to over 5 (from 3 or less).
ALC cut in half (from around 1500 to 800).

Not sure what any of that means other than those ranges are in the “higher risk” ranges and its making me worry that progression will be the topic for next scans coming around week of Feb 15th. Although he’s still symptom free from the esophageal cancer itself (thank goodness for some blessing).

Day by day.

February 11, 2016 at 8:52 pm  #1272948    

Cheryl3700

Hubby has been getting severe panic attacks the day after chemo. They tried chemo without dexa steroid and that caused worse issues. Now doing prednisone and still having the attacks. Just had 2 tonight, these are horrible to watch, he’s beside himself, arms, legs flailing, lying in bed crying, moaning, moving side to side, can’t talk. He says it starts with feeling of indigestion in chest, not pain but bad discomfort. We tried preemptive strike of ativan every 4 hrs today, but yet he still had the attacks.

Anyone have suggestions or experience with this?

Thanks so much.

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