Lung cancer with pleura thickening - 1254603

fightingcancer
Posts:3

My husband has stage 3b or 4 LC adenocarcinoma. Dx in Nov 2012. Located in the middle of the lung with pleura thickening. All other areas are clear. it is close to the aorta. His CT scan on 2/13 showed a little improvement. Two weeks later the PET showed improvement but some new areas. I am still confused about the pleura thickening, ,what it is as opposed to pleura fluid. They were considering VATS after the CT, did the PET two weeks later and after that surgery is not an option now. The PET showed some areas in the pleura resolved , but two new areas. We were told the pleura was cancer. This was his second PET but all along we have been told they were not sure the pleura was cancer. Now they say it is. We have not had a biopsy on this. I would like to know why surgery cannot be done if the pleura is cancer. I am also surprised that the cancer spread that fast after only two weeks. Is a CT that less accurate than a PET or is the cancer spreading that fast? He has been on chemo since Dec. the CT was on 2/13, chemo on 2/19 and the Pet on 3/5.

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Reply # - March 10, 2013, 12:27 PM

catdander
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Hello and welcome to Grace. From a search of previous posts, Dr. West described pleural thickening as, " Focal nodular pleura thickening means that there are some specific areas where the lining around the lung is thicker, which could be from inflammation, or infection, or possibly cancer." http://cancergrace.org/forums/index.php?topic=1036.0
It sounds as though your husband has had some treatment since diagnosis. Once lung cancer travels through the blood or lymph system it is considered out of the realm of cure. It would depend on where the cancer is thought to have traveled. Dr. West states that it's one the most common questions when talking about metastatic spread. Here is a discussion on it from our FAQ section. http://cancergrace.org/cancer-101/2011/01/01/cancer-101-faq-i-have-meta…

I hope this will help start explaining why his doctors have decided not to do surgery. A second opinion may also be in order. As you know this is a very important step and you want to understand that your husband is doing everything he can. http://cancergrace.org/cancer-101/2011/11/13/an-insider’s-guide-to-the-second-opinion/

Janine
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Reply # - March 10, 2013, 01:48 PM

Dr West
Posts: 4735

It's certainly true, though unfortunate, that lung cancer involving the pleural lining can't successfully be surgically removed. It isn't the recommended approach because the cancer pretty close to invariably returns if surgery is pursued, and the surgery is a great deal to go through -- justified if there's a realistic chance for cure, but not otherwise.

It's not unusual to get more information from the combination of the CT and PET than from either alone...and yes, seeing how things change over time also provides helpful information.

Good luck.

-Dr. West

Reply # - March 14, 2013, 01:17 PM

catdander
Posts:

Just an FYI, I'm sure Dr. West meant to write in his last post, first pp, last sentence,

...and the surgery is a great deal to go through — justified if there’s a realistic chance for a cure, but not otherwise.

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