My husband was diagnosed with stage IV non small cell lung cancer adenocarcinoma with bone mets.left upper lobe biopsy and bone scan PET scan done in Sept 2012. Bone mets to L2,3,4,5 and S1 pelvic area,sternum and left ribs. Mutations negative. Had 6 chemo treatments of carbo, alimta, and avastin. Xgeva shot every 3 wks. Now has maintenance alimta and avastin every 3 wks. Pet scan on 04/24 says that T9,10, and 12 have progressed activity and remain sclerotic, somewhat unusual for lung primary. Correlation to PSA level is recommended more typical of prostatic metastases. All per Dr reading the PET scan. My husband never had a PSA test done. He hasn't seen his onc yet. Could the cancer have started in the prostate and spread to the lung and bones? Could the biopsy of the lung tell us that it started somewhere else? We are so confused right now. Could this be possible.
Misdiagnosed as lung cancer? - 1256028
kimmt
![]()
Posts:1
Forums
Reply # - April 29, 2013, 05:59 PM
Reply To: Misdiagnosed as lung cancer?
Hello kimmt,
Lung cancer cells and prostate cancer cells are different under the microscope, and although errors can occur in the lab, I would be more confident in the lab results than the speculation of a radiologist who has only scan images to interpret. If prostate cancer spreads to another part of the body, those cancer cells are still prostate cells, and vice versa - lung cancer metastases are lung cells wherever they appear in the body. So the lung biopsy should have made it clear that it is lung cancer. On the other hand, sometimes the cells have mutated so much that it becomes difficult to determine what kind of cells they were originally. So you may want to ask your husband's doctor how well differentiated the biopsied cells were. That will give you an idea of how confident the doctors are that this is lung cancer.
JimC
Forum moderator
Reply # - April 29, 2013, 07:39 PM
Reply To: Misdiagnosed as lung cancer?
JIm's absolutely right. The radiologists don't actually ever see or manage real patients, so these comments are really just shooting from the hip. They should be taken as speculation, not literal insight. As Jim noted, the biopsy should be able to readily distinguish a cancer of prostate origin from one of lung origin. Moreover, it would be far more common for a lung cancer to spread to the bone than for a prostate cancer to spread to the lung, so I would have a very, very low suspicion that this is actually a prostate cancer unless there was a lot of ambiguity on the original biopsy. They can stain the cancer cells for PSA, which will almost always be positive in prostate cancer, so the pattern of proteins on the cancer cells would have a high probability of distinguishing one from the other.
-Dr. West