I posted a question here about a week ago and now I cannt find it. I am new to this forum, in December wanted a ct scan for lung cancer screening since I was at high risk had smoke for a long time 40 yrs just recently quit. They saw a 1cm nodule slight irregular in RUL, GP sent me to a thoracic Dr, thoracic Dr took blood work, ordered pet/ct, pulmonary and then needle biopsy. Had pet on wednesday, had pulmonary today and more blood work. arterial blood gases. So far I have had three different radiologist read my last three ct scans. pet lite up on nodule states focal increase accumulation with uptake value 7.4 max. First radiologist said it was 0.9 x 0.1 slighty irregular soft tissue. this radiologist says it measures approximtely 1.3 x 1cm spiculated lesion. He states there was no other lung lesions that could be beyond the threshold of resolution of the pet technique. no evidence of enlarged non-hypermetabolic lymph nodes, liver and bony structures normal. He states hypermetabolic mass in the right upper lobe consistent with a broncheogenic carcinoma. no evidence of hilar or mediastinal nodal involvement or distant metastases. First radiologist n 12-13 said mild emphysema bullae more on right upper. this radioligist says emphysema with numerous subpleural blebs. had pulmonary funtion test, do not know the result yet, only know that my 02 was 100% and blood gas was 88% which my gp says normal is between 80-100. Couple questions Please Dr West or anyone else:
Needle biopsy is scheduled for 2-14 only because the Dr they want that is her first available. Ok worried just want to hopefully be able to get it out with Vats before its decides to grow bigger. Worried that the difference in size is 3mm in a month, but both gp and thoracic Dr says these are estimates, two different radiologist and not much difference. GP seems concerned Thoracic Dr seems unconcerned. I know that 95% this is cancer, but is there a 5% chance it might not be eventhoug
Fri, 02/01/2013 - 21:04
Have to start a new post must have ran over. anyway is there anything other kind of lesions that would lite up? not that I am asking for false hope because I'm not I am resign to the fact this is cancer. I'm just wondering why a surgeon if he has a chance to get something out while it small, why not just do the needle biopsy during the surgeon, I have read where alot of people forgo that procedure and just have the surgery and it worrys me that if his thing grew 3mm in over a month I should not be waiting two weeks for a biospy. any help would be appreciated. Thanks mickey
Fri, 02/01/2013 - 21:58
In a recent trial done in collaboration across many institutions in North America, 18% of the lung nodules that the doctors were pretty confident were cancer and were taken out at surgery weren't actually cancer when they looked under the microscope. They were things like a focal area of inflammation or infection. So nearly 1 in 5 who had a lung surgery for something felt very likely to be cancer after the full workup prior to surgery didn't have cancer after all.
That's why the doctors want to get a biopsy before proceeding to take out a large piece of your lung.
Sat, 02/02/2013 - 07:25
Dr West, you are a very caring and kind person, wish you were in my State, I would definetly want you as my Dr. I understand what you are saying and you make so clear. I understand that surgeons are just surgeons and are not like your primary care Drs who see y all the time and develope a relationship with you. the thoughts go through my mind every single minute of the day, what if we wait too long, once it spreads then your chances go down and Dr google does not help. Most people that respond to me are caregivers and cargivers are wonderful wonderful people but I have been there and done that with my father who died of bladder cancer and its a whole new world when it hits you. Its funny how you see more caregivers on cancers sites then actual patients.
OK so two more questions in your opinion, what does a radiologist mean when he says hypermetabolic, I have read many different forums some say the meaning of that is fast growing and that is what scares me to death. I'm not sure how long I had this nodule but I'm thinking about 6 months no longer. Cat scan from 2011 was clear. Next question would be that 0.9 x0.1cm in dec and then 1.0 x 1.3 change from one radiolgist to another, not sure how how small 3mm is but in my mind it is a difference. Third and final question is first radiologist said suspicious of neoplasm, pet radiologist says consistent with bronchogenic carcinoma, first one call it a mass, second one called it a lesion, its the bronhogenic that really scares me, all Drs said RUL, but when I look up this it show bronchial (think i spelled that wrong) tubes, is this things in my bronchial tubes, is so why are they doing a needle biopsy, if its outside my bronchial tubes could it be blocking my airways or going to do so. Who would I ask to get this information, the thoracic Dr????. Sorry for all the questions but if you could answer those three in your opinion I would greatly appreciate it. Thanks Mickey
Sat, 02/02/2013 - 14:34
[i]Hypermetabolic[/i] means that it is taking up more sugar than surrounding areas, which suggests the cells there are growing and dividing faster. The measurements you offer don't really make a lot of sense to me: I'd be very surprised if a lesion measuring 0.9 x 0.1 cm in Dec grew to 1.0 x 1.3 cm -- that difference from 0.1 to 1.3 cm is hard to believe, frankly, if the other dimension grew by just a millimeter.
As for the terminology "bronchogenic" just means "originating in the lung". That radiologist is saying it's suspicious for being a lung cancer. As for the terms of "mass" or "nodule" or "lesion", that's just semantics. While technically a nodule is supposed to be under 2-3 cm and a mass is larger, people use the terms interchangeably, and "lesion" is just a medical term for a spot. So you're really looking for more precision than the report includes, which is why we don't want to try to interpret scan reports here, as we don't have all of the information we would have if directly involved.
Sat, 02/02/2013 - 15:01
Thank you Dr West as always you are so kind. If they inject sugar into you and it goes right to that spot or lesion is they any thruth to "don't eat sugar" because cancer cells need sugar.
Thanks again, I sure wish you lived in my state! You are an awsome Dr.
Sat, 02/02/2013 - 15:21
I'm sorry Dr West first report said 0.9 x 0.1cm then stated 1cm mass. Second report said 1.3 x 1cm approximately (that word comes right after the measurement). Does that make better sense, I went back and read it? I guess that would be width and lenght? So I assuming the reading is a difference of 4mm one way? or does it still not make sense? Thanks again Mickey.
Sat, 02/02/2013 - 19:21
It makes far more sense, and it suggests that it's growing at a rate that merits further evaluation, either a biopsy or having it removed if a biopsy can't be done or one is done and it's non-diagnostic (no real answer).
Sat, 02/02/2013 - 19:30
The only way to tell if it's cancer is through a biopsy,which you say you have one scheduled. That's all you can do for now until you have results. Wishing you the best. Take care, Judy
Sun, 02/03/2013 - 09:50
Thank you Judy and Dr West. I have the biopsy scheduled but its not till the 14th, my fear is two weeks is too long, I know its sound crazy. My thoracic dr said that difference could be the way the radiologist measure differently, it that true in your opinion and Dr West what is the first the width or the length. Can a thoracic Dr look at a pet scan or ct scan and measure it?. So would you call this nodule by what I have given you in my posts in your opinion a 1cm nodule or a 1.3 nodule? How big is this nodule compared to something like a plum etc.
Sun, 02/03/2013 - 10:08
Sorry but those 0's are totally confusing, so 0.9 is one mm of of 1cm and 0.1 is 1cm? or not? or this 9mm of a centimeter the first report eventhough it has 0.1cm its says it is a 1cm mass. Please clear up my head on this it seems like a big change a hugh change. Thanks
Sun, 02/03/2013 - 12:22
Hi mickey, I know this is a very confusing time and you're trying to make sense out of some very complicated information.
It sounds like your nodule is about the size of a black eyed pea.
See if this makes any sense:
and so on
there are about 3 cm in an inch.
The zero before the decimal point just means zero, so 0.9 = .9
.9 and 1 are very close to the same size especially when talking about cm.
Your doctor or the radiologist writing the report stated a nodule .9 x .1 cm (or in mm that's 9 x 1 mm) that's about the size of a black eyed pea or possibly a purple hull pea. :wink: Some radiologists and your doctor just use the largest of the 2 measures. Yours being 1 cm ( or in mm, 10 mm)
I hope this turns out to be benign. Best of luck.
Sun, 02/03/2013 - 13:56
Catdander thank you so very much for your reply! I really appreicate it, all these tests and everything else are going around in my head like a lighting bolt, I cry most of time, find I can't do anything most of the time and just thinking ahead to a death sentence, buying some time and the horrible future ahead of me. I know I sound like a basket case which I am, I have had such a rough time all my life, try to face everything with an upbeat attitude but I am really really breaking down now, almost to the point where I can't even function. Maybe I should explain a little bit, I have no family, my dad died almost 10 years ago of bladder cancer, have one brother who does not know I am alive and live in another country and if I talk to him once every two years for 5 minutes thats a lot and yes he knows about this and has not called me once. My husband cannot deal with this very good, stays away from me and the house, I am a caregiver to my 91 years mom who has numerous health issues and a little demetia which is aggravated by this. One son who has numerous physical/mental issue and has been in and out of hospitals. And to top it all off I am the main financial supporter for this family so I'm worried about my job and everything else.
Sorry for the long reply, just wanted to give you an update. I wish I had never smoked or had quit along time ago but that did not happen. I know its cancer the pet lite up on that nodule like a christmas tree, 7.4, no valley fever, no TB, no MAC etc plus its not round. I am so hoping that I can have the vats, but that will depend on my pulmonary because I have emphysemic changes with blebs or bullae. Thank you again for you reply and I keep praying I just don't feel any peace and I know Gods not going to answer my prayer.
Thank you again! Mickey
Sun, 02/03/2013 - 17:55
Hi Catdander, can I please ask a question for you and Dr West? I read this on one of your reply's, I'm particularily interested in the part that says "Note".
Are you saying that chemo does not provide a cure for lung cancer? so if you have lung cancer and you cannot have surgery and you have to have chemo it just a short fix and probably can never be cured.
Here is what you wrote in your post:
There are several pieces here. If she is being given chemo as part of a curative treatment one may be willing to push the envelope of more toxic side effects and even safety than if being treated for stage 4/quality and lengthening life.
(note that chemo alone doesn’t provide a cure in the setting of lung cancer)
I also want to ask you or Dr West about cyber knife, is it used in lung cancer? with any results.
Sun, 02/03/2013 - 19:53
Chemo for stage IV non-small cell lung cancer isn't a cure. chemo can contribute to higher cure rates for stages I-III NSCLC.
Cyber knife is sometimes used in specific circumstances in lung cancer, primarily for isolated brain metastases. Focal radiation to the chest is sometimes done as an alternative to surgery, in which case it's called stereotactic body radiation therapy (SBRT).
I think it could be a mistake to try to anticipate every option that might follow, when there's still so much that needs to be determined about what's happening. It will be far more feasible to become well educated about the options when you learn more about what the situation actually is.
Mon, 02/04/2013 - 08:37
Dr West I can't thank you enough for taking the time to reply to me. I have one more question please, from looking around on different forums, I have read a couple of troubling recent post concerning needle biopsys from several different people. They honestly believe that by having a needle biopsy it has and can caused the cancer cells to get in the blood stream and spread. Well that sure put a hugh worry in my mind. Could you answer that in your opinion. On one hand it makes sense, put a hold in your lung and let the cancer cells escape. There used to be an old theory that some said once the air hits it, it spreads. So here is my question, what is your opinion on that and how fast does the lung close up after that needle is put in, fast or does it leave a hole for awhile before it heals?
Thanks again Dr West. Mickey
Mon, 02/04/2013 - 13:25
I think what you're talking about is called seeding and it doesn't happen in lung cancer or at least only on rare occasions (anything is possible). It's much more dangerous not to know if you have this disease that needs attention.
The one about spreading when air hits it doesn't pertain at all. That was a long ago guess of why people died soon after they had surgery that found cancer. In reality the cancer was metastasized to the point of near death when cancer it was found.
Mon, 02/04/2013 - 17:02
It's really very rare in lung cancer, and that idea is mostly perpetuated by people with very little medical knowledge. I think that the value of going online for information about cancer is only if you're seeking it from people who actually know something about what they're discussing. It's pretty harmful if you just have people who are actually ignorant about the subject just perpetuating unjustified fears and scaring each other.
You'd probably be better off staying away from the sites featuring more bad information than good information. I wouldn't have started GRACE if the cancer-related content of what's available elsewhere did a reliably good job.
Tue, 02/05/2013 - 17:48
Hi Mickey. . . I just wanted to wish you lots of luck with your biopsy. . .here's to it being absolutely NOTHING!!!!
Tue, 02/05/2013 - 19:17
Mickey61 I have found if I click on The right the recent Grace Forum Activity it makes it easier to find things I've posted recently. Might I also add I am praying for good News for You!
Wed, 02/06/2013 - 11:46
Ever so Happy You did form the Grace site! It is so reassuring to get answers from actual Dr's! Thank You again!