A lesion found on the chest xray in the left apex

Portal Forums Lung/Thoracic Cancer Work-Up/Staging of Lung Cancer A lesion found on the chest xray in the left apex

This topic contains 9 replies, has 4 voices, and was last updated by catdander forum moderator catdander forum moderator 1 month, 1 week ago.

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February 23, 2017 at 6:57 pm  #1290188    

okm7954

HI, I am a 63 yr old female, non smoker, but grew up in a home where both parents smoked heavily. My dad died at 51 from lung cancer.

Two years ago I went to orthopedist with left shoulder pain that went up my neck and down my arm to the elbow and little finger. The orthopedist focused on my cervical MRI and told me it was normal changes for a 61 yr old woman. Told me to take NSAIDS and it should be ok.

Now the pain is unbearable and I can’t sleep at night, taking Tramadol at night and use a heating pad to fight the pain. A year ago I started to become hoarse and saw an ENT. She did not see anything on my vocal chords and told me everything is a ok. I still have a hoarse voice and people have a hard time hearing me on the phone.

Last week I saw my PCP because I have become short of breath, even speaking is difficult. The chest xray came back with a nodule/lesion in the left apex. The doctor called me within 2 hours of having the xray and told me about the lesion. We are now waiting for approval of the chest CT.

I did some research about cancer in the apex area and was led to pancoast tumor. But I noticed that most patients were smokers for several years. I am trying not to get nervous mainly because I am not a smoker and that this tumor is rare.

I did notice that some doctors prefer MRI over CT for the apex view. What are your thoughts out there about CT vs MRI?

Thanks for listening and hoping this little bump in the road is not going to be a neoplasm.

Kay

February 24, 2017 at 5:31 am  #1290191    
JimC Forum Moderator
JimC Forum Moderator

Hi Kay,

Welcome to GRACE. I am sorry that you are experiencing these symptoms, and I share your hope that this is not cancer.

As far as the question of MRI vs. CT, Dr. Pennell has stated:

“…a CT of the chest with contrast would be the most common test to look for a lung cancer, including a Pancoast tumor. An MRI is sometimes done to see if the tumor is invading into the brachial plexus, as you mentioned, or perhaps the spine if one was considering surgery, but is not the usual first scan for diagnosis. As long as it includes the apices (tops) of the lungs, though, an MRI would probably get the job done. It isn’t an ideal test for the lungs as it requires a longer time to generate the images and people just can’t hold their breath for 30 minutes so there tends to be lots of motion “artifact” or blurring in the lung images. For the apex, though, to see a Pancoast tumor, it might be fine.” – http://cancergrace.org/topic/pancoast-tumor-diagnostic#post-1268999

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

February 24, 2017 at 9:30 am  #1290195    

okm7954

Thank you Jim for clarifying that for me. Yes I am staying positive that this will be nothing. I will post an update after the CT.

Thanks again,
Kay

February 25, 2017 at 4:29 am  #1290201    

cards7up

Did they say what size the lesion is? Pancoast tumor is called that due to the location of the tumor. A biopsy would have to be done to get the type of cancer if it is cancer at all. Even the CT won’t provide the answer but shows a suspicion for. And then a biopsy would be done to confirm. Good luck!
Take care, Judy


Stage IIIA adeno, dx 7/2010. SRS then chemo carbo/alimta 4x. NED as of 10/2011.
Local recurrence, surgery to remove LRL 8/29/13. 5.2cm involved pleura. Chemo carbo/alimta x3. NED

February 25, 2017 at 9:25 am  #1290204    

okm7954

The report read 4 cm. They tried to do a apical lordic view, but my 1st and 2nd ribs were in the way. I was a bit concerned, but trying to focus on the fact I am a non smoker and this just might be a cyst. Staying positive and thank you. Kay

February 25, 2017 at 1:13 pm  #1290211    

cards7up

The next step would be a PET scan. They can biopsy via a bronchoscopy. If it’s 4cm, then it should be biopsied. Take care, Judy


Stage IIIA adeno, dx 7/2010. SRS then chemo carbo/alimta 4x. NED as of 10/2011.
Local recurrence, surgery to remove LRL 8/29/13. 5.2cm involved pleura. Chemo carbo/alimta x3. NED

March 9, 2017 at 6:33 am  #1290299    

okm7954

Going in for my CT scan this am, will be seeing my doctor on Monday afternoon.

March 9, 2017 at 8:50 am  #1290306    
catdander forum moderator
catdander forum moderator

Finger crossed for good news!


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?

March 14, 2017 at 8:02 pm  #1290366    

okm7954

Good news it is not cancer, but I have emphysema. thank you for your support during the waiting. Kay

March 15, 2017 at 12:34 pm  #1290374    
catdander forum moderator
catdander forum moderator

That’s great news Kay! I hope you do well moving forward.
All best,
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?

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