Radiation for Lung Cancer without biopsy?

Portal Forums Q&A, Ask Us New Questions Radiation for Lung Cancer without biopsy?

This topic contains 5 replies, has 2 voices, and was last updated by catdander forum moderator catdander forum moderator 1 week, 5 days ago.

Viewing 6 posts - 1 through 6 (of 6 total)
Author Posts   
Author Posts
April 4, 2017 at 11:06 am  #1290507    

debbiea62

I have a spot on my lung and they can’t do a biopsy because it would be too dangerous. I have COPD. They want to start radiation therapy immediately. They said it looks like cancer as a result of a PET scan. I’m not sure I want to do the radiation. I’d rather wait 3 months and get a repeat CT and see if it has grown. I need opinions. Thank you!

April 4, 2017 at 1:37 pm  #1290508    
catdander forum moderator
catdander forum moderator

Hi Debbie,

Welcome to Grace. I’m sorry you’re in this position but it’s still quite possible you don’t have cancer.
We can’t give opinions on what you should do but we try to help with as much education, quickly on a complicated subject. I think a good place to start when looking for the answer is to know that in most cases it depends on the individual. Some say each is a unique cancer.

Most oncologists can tell you of lots of times when something looked like cancer on a PET but wasn’t. It’s why biopsy is so important. But then again a biopsy is invasive and can cause problems of their own. Sometimes a scope through the nose or mouth can reach a mass and collect cells enough to biopsy. The scope is much less invasive and a pathologist or pulmonologist can tell you if a scope is likely to reach.

I’d be curious why the doctor wants to move so quickly. There might be a reason. How will you ever know if you had cancer if you have radiation and no cancer grows. If a mass isn’t causing problems then it’s not likely to cause significant problems while you take your time and find out what’s going on.

Cancer treatment is still very toxic and carries its own set of adverse effects, radiation included so you want to be as sure as possible. “Interventional pulmonology is a new field within pulmonary medicine focused on the use of advanced diagnostic and therapeutic techniques for patients with lung cancer, airway disorders, and pleural diseases.” https://medicine.duke.edu/divisions/pulmonary-allergy-and-critical-care-medicine/about/division-programs/interventional If you haven’t seen one it would be helpful with decision making. Large teaching hospitals with a lung specialty will have an interventional pulmonologist with whom you could have a 2nd opinion.
This post is an excellent explanation of benefits of a 2nd opinion. http://cancergrace.org/cancer-101/2011/11/13/an-insider%E2%80%99s-guide-to-the-second-opinion/

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?

April 5, 2017 at 10:22 am  #1290513    

debbiea62

Thank you so much Grace for answering my question. One of the first questions I am going to ask is if we can wait 3-6 months and do a repeat CT to see if it has changed. I will read your links and I am also planning on getting a 2nd opinion. My PET scan showed 1 small spot that showed “hot” and so did some inflammation I have in my shoulder. I don’t understand the difference. I agree. No need to rush since we don’t even know what type/stage cancer it is. I have a lot of questions to ask and am taking a friend to write down what he says. I also have panic disorder/agoraphobia which is making all this harder.
I’m worried about what the radiation will do to my lungs. I have emphysema. That’s why they couldn’t do biopsy. Thank you again. I will follow up with what he says.

April 5, 2017 at 1:19 pm  #1290514    
catdander forum moderator
catdander forum moderator

Cancer and inflammation show up the same on a PET. This is why, unless there are symptoms it’s most appropriate to watch and wait to see what it does on it’s own. If there are symptoms an interventional pulmonologist will have the best ideas of what to do next. Radiation isn’t normally on the radar after only a PET shows a lit up spot on the lungs after all it could be infection or other inflammatory process.

Radiation does kill tissue that is in the path which is good if it’s cancer but if it is lung tissue you don’t want to do without it especially with COPD.

Best of luck,
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?

April 12, 2017 at 11:46 am  #1290571    

debbiea62

I had my visit with the Radiation Oncologist and boy was I surprised! He said he was 95% sure it was not cancer and recommended we do nothing and repeat the CT scan in 3 months to see how it looks. Between the CT scan and the PET scan (28 days) the spot had gotten smaller. Thank God is all I’ve said since Friday! Just wanted to let you know, since you have been so supportive. Thank you so much :) and God bless you.

April 12, 2017 at 1:30 pm  #1290572    
catdander forum moderator
catdander forum moderator

YEAH DEBBIE! So glad to hear it. It’s probably an infection or something similar. Aren’t you glad radiation oncologists are not eager to treat without proof?

Thank you for the follow up. It’s good for others to see as well.

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?

Viewing 6 posts - 1 through 6 (of 6 total)

You must be logged in to reply to this topic.