Pancoast Tumor

This topic contains 11 replies, has 5 voices, and was last updated by catdander forum moderator catdander forum moderator 3 weeks, 3 days ago.

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April 5, 2017 at 7:31 am  #1290509    

sunnyahuja120690

my Name Is sunny.

My problem Is i Have right shoulder pain that radiate to bicep and wrist.

Smoked Hukah For 3 to 4 Years.

i went for HRCT Thorax..

Report Came Clear.

But Still I have Shoulder and arm pain..

so is HRCT Use full to detect Pancoast Tumor…

Or any other Test is Required..

Thanks.


sunny

April 5, 2017 at 7:32 am  #1290510    

sunnyahuja120690

Small Upadte my age is 28.


sunny

April 5, 2017 at 9:51 am  #1290511    
catdander forum moderator
catdander forum moderator

Hi Sunny,

Welcome to Grace. It’s true a CT especially a hi res CT would pick up a pancoast tumor. You’re probably looking for something less complicated. I have to admit we get a lot of people who have shoulder pain that radiates down the arm who are worried they have a pancoast tumor. I hope you also find that there are other much more common and probable reasons why this is happening. The odds are extremely small that a 28 year old with a small smoking history has lung cancer add to that the rarity of a pancoast tumor especially without a significant smoking history. A nerve that is pinched or damaged is tons more common than a pancoast tumor in a 50 year old with a smoking history. I hope you get this resolved hopefully through physical therapy.

All best,
Janine
forum moderator

April 5, 2017 at 10:08 am  #1290512    

sunnyahuja120690

Thanks Janine.

And i Appreciate Your quick response to my post..

well i got married just year ago…so i was worried…coz i dont wanna die so soon…

well as u said i’l definitely go for physio therapy…

and will definitely inform you once i get better…

Got some relief Thank you SO much…


sunny

September 10, 2017 at 5:57 am  #1291605    

sunnyahuja120690

Hi…and sorry for the trouble i am giving you.

i had HRCT in feb 17 came clear.

again i had chest x-ray yesterday…came clear,but showed bronchitis.

still i have pancoast symptom like, shoulder pain,fore arm pain,pinky and ring finger pain,upper back pain,collor bone pain.

so i am worried is pancoast missed on ct and chest x-ray.

plz help.


sunny

September 10, 2017 at 8:15 am  #1291606    
JimC Forum Moderator
JimC Forum Moderator

Hi sunny,

The type of shoulder/arm pain produced by a pancoast tumor is much more likely to be caused by other ailments. This is especially true for younger patients (certainly patients in their 20s and 30s) and persons without a significant smoking history. In a podcast, Dr. Vallieres describes the typical scenario reported by patients as “enormous pain around their shoulder and down their arm, sometimes some changes in their facial expression, who had, on x-ray, a tumor at the top of their lung.”http://cancergrace.org/lung/2015/09/11/gcvl_lu-e06_pancoast_tumor_history_treatment/ As with most cancer pain, it is unlikely to come and go or vary in intensity but more likely to be constant and increase in severity over time.

It’s important to note that a pancoast tumor usually shows up on a chest x-ray, and certainly on a chest CT. As Dr. West has said:

“I think a Pancoast tumor may be the most over-internet diagnosed problem in the cancer world — at least lung cancer. It is extremely common for people vanishingly unlikely to have a Pancoast tumor to scare themselves half to death by a Dr. Google diagnosis. It is overwhelmingly likely that you do NOT have a Pancoast tumor. And while a chest x-ray is a very old technology and CT is better, a chest x-ray would be sufficient to all but prove that it ISN’T a Pancoast tumor.”http://cancergrace.org/topic/very-scared-of-pancoast-tumor-please-any-advice#post-1272705

I will add that I’ve been active on GRACE for 8 years, and the type of question you post is not uncommon. In that time, I can’t think of a single case of a person who is unlikely to have a pancoast tumor and whose imaging has not revealed such a tumor but later has returned to the site to report that diagnosis. With that in mind, since you already have chest x-ray and CT reports which do not reveal a pancoast tumor, I would feel reassured and turn my attention to other possible (and less concerning) causes for your pain.

[continued]


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

September 10, 2017 at 8:18 am  #1291607    
JimC Forum Moderator
JimC Forum Moderator

[continued]

I hope that you can find answers that will aid in resolving your symptoms. If you haven’t already, perhaps a consultation with an orthopedist would be in order.

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 10, 2017 at 12:59 pm  #1293620    

kaylababez

Hi my Mum was having shoulder pain. Shortness of breath and fatigue also her left eye went droopy so she went to a n e and they said it looks like she has horners syndrome and took her for a chest X-ray where they confirmed Horners syndrome and found a mass on top of her lung. She then went on to have a ct scan and a mri scan. Also blood tests. They haven’t told her what they think it is or anything. But we have read up and found Pancoast tumor sounds right!! I’m very scared they told us horners and her lung mass are associated.. they have referred her to the multidisciplinary lung team and they are having a meeting on Tuesday. Does this meen they know what it is? She is also waiting for a biopsy. Please help. Thanks.

December 10, 2017 at 5:02 pm  #1293621    
JimC Forum Moderator
JimC Forum Moderator

Hi kaylababez,

Welcome to GRACE. I am sorry to hear that your mum has been experiencing these symptoms, and that the scan findings have caused you such understandable worry . One thing can be said with certainty: the doctors do not “know” whether your mum has a pancoast tumor. The scan results may cause them to suspect it (perhaps among other possibilities they are considering), but the only way to make a definitive cancer diagnosis is by testing the cells collected from a biopsy of the lung mass.

The interdisciplinary meeting to which you refer is a common occurrence at medical centers. It gives a doctor in one specialty a chance to interact with experts in other areas of practice to discuss a particular patient’s case, looking for the varying types of insight which each specialist may provide.

I know that the time period waiting for a diagnosis and a decision on treatment is difficult to endure, but please don’t feel as though the doctors know something that they are not revealing. When a diagnosis is still pending, they tend not to speculate until all the data is in place. In your mum’s situation, they may have the necessary data after the biopsy results are in.

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

June 25, 2018 at 5:36 am  #1294655    

sunnyahuja120690

Hello sir,

i still have same feeling that i have pancost tumor, because i have each and every symptom
of pancoast tumor.
like shoulder pain. fore arm pain. right side upper rib pain,

even i went to the eye specialist to check up for horner syndrome.

and he said there is no horner syndrome every thing is normal with eyes.

i have done HRCT scan 18 months ago….it came clear.

so my question is do i have pancoast tumor…or something else.

upper rib pain and shoulder blase pain is constant..


sunny

June 25, 2018 at 7:37 am  #1294658    

onthemark

Hi Sunny,

I am sorry to read you are still in pain. I would go to the doctor and ask to get some xrays of the shoulder and rib, a referral to physiotherapy and/or massage and a diagnosis of what is causing the pain.

I had this kind of shoulder pain once and started to worry it might be a recurrence in the form of a pancoast tumour, but it went away after several professional massages and I feel much better.

Given you already had a ct scan, and the duration of the pain, and most especially your age, it is very unlikely that the source of your pain is a pan coast tumour. I hope this relieves some of your worries.


10/2015 Chest xray found a nodule as part of a physical (no symptoms).
01/2016 Upper left lobe lingula preserving lobectomy stage 2b for 1.9 cm invasive adenocarcinoma with additional 2 mm AIS nodule found in pathology.
03-05/2016 Sixteen weeks of adjuvant cisplatin/vinorelbine.
07/2016 Durvalumab adjuvant clinical trial discontinued after 1st dose knocked out thyroid.
12/2016 Revised to stage 1b (due to VPI) after new guidelines for multifocal lepidic lung cancer.
07/2019 Next scan.

June 25, 2018 at 12:12 pm  #1294661    
catdander forum moderator
catdander forum moderator

Hi Sunny,

Most often this pain isn’t a pancoast tumor. My husband had a pancoast tumor and when he was having pain in his shoulder and arm his description sounded just like the pain I get when I’m not actively caring for damage to a cervical nerve. In retrospect I see there were differences because his pain was coming from rib and bracial plexus destruction. An MRI given him didn’t pick up the tumor because the mri only looks at a small area and his tumor either was hidden behind bone or it was looking at an area not at all effected by the tumor. Pain in the ribs suggests damage to the ribs and would be picked up by a simple inexpensive xray to that area. An xray of the top of the lung where the tumor would have started would also be picked up by an xray because the pain you’re having suggests if it’s a pancoast tumor it’s large enough to be picked up by an xray. And certainly a chest ct would pick it up. I’m sorry that you continue to have problems. I think onthemark’s suggestions are good and I hope you get to the bottom of this. Nerve damage can be elusive and painful and difficult to manage.

All best,
Janine

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