second hand smoke- how close is too close? - 1257749

catnapt
Posts:22

Hi,
I am 57 years old. I lived with heavy smokers for 18 years, I have an overlapping history of smoking from age 15 to 30 (with probably ~ 12pack years)

A tiny nodule (3mm) was found in my right lung as a result of a work up for a GI issue.

I have avoided second hand cigarette smoke as much as I possibly can, renting only in non-smoking apt buildings, etc.

Other tenants where I now live are ignoring the no smoking rule and smoking indoors, and the smoke- or at the very least the smell of cig smoke- is filtering into my apt.
It is so bad that it is making one of my cats sick- she is vomiting and now will not eat & I have a mild cough that I did not have before.
It's been 27 yrs since I quit smoking so I am not horribly worried about that small nodule being lung cancer, but still, if it is, could this amount of second hand smoke make it grow faster?

Does smelling cig smoke mean you are exposed to the toxins, or can you just be exposed to the odor and just annoyed by that but not at increased risk?

On a related note- the cigarette smoking makes me very very angry. (yes I've contacted the landlord but he doesn't live here and is limited in what he can do- he'll send them a reminder about it being a non smoking building, but really he's more interested in not losing any tenants)
Part of my anger is at myself, because it reminds me that I used to smoke and I feel helpless to erase any damage that may have done to my daughter and to myself.
Part of my anger is at the smokers for exposing me to something I have tried so hard to get away from.

I tried to find studies about the effects of emotions on cancer growth with no luck. I know that anger affects my heart.

Could my reaction to the smoking be worse than the actual smoke itself?

My mother, father and step father all had lung cancer. My uncle died from smoking related throat cancer. My brother has COPD.

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Reply # - July 6, 2013, 06:26 PM

Dr West
Posts: 4735

Unfortunately, I don't think there's any real research to address your questions about the extent of risk conferred by the smell of smoke and rather distant smokers. I think the probability that this is going to translate to any worsening of the biology of the nodule you're following is exceptionally, unfathomably small -- probably far, far less than the risk posed by the building potentially catching on fire.

Good luck.

-Dr. West

Reply # - July 6, 2013, 06:37 PM

Dr West
Posts: 4735

I was only half kidding. I don't think you should stay awake worrying about the building going up in flames, but I am serious in saying that the risks from second hand smoke are unbelievably small compared with the real risks that don't paralyze us, like the drive commuting to and from work, etc. The stats about risks of flying being less than those of driving are a real example, and one most of us have heard that we tend to remember, that should serve as an example to keep everything in perspective rather than focus excessively on one small aspect for our worries.

And it's not foolish. Many people are very anxious about the long term risks posed by repeat scans over time, but I suspect that the risk of driving to and from the scan dwarfs the risk of the scan itself. We all worry more about some things than we should based on the real probabilities and statistics.

-Dr. West

Reply # - July 6, 2013, 06:54 PM

catnapt
Posts: 22

I understand. I am nearly falling off my chair laughing at myself now.... I don't drive. Too afraid I'd kill someone.

But that aside, I totally understand.
Funny thing is, when my parents got lung cancer within two years of each other, I tried to find out if there was any early screening for it. Because of course, finding cancer early is best, right?
And am I now living what I found out: that it only causes anxiety and unnecessary procedures, etc.

I still hate the smell of cigarettes though. ;-)

Reply # - July 6, 2013, 08:59 PM

Dr West
Posts: 4735

If you do a search for "screening" here, you'll find posts that include a serious discussion of the anxiety and extra procedures as a serious downside of screening for lung cancer. Many people, and probably even most, have tiny nodules, and most of them don't turn out to be cancer, but they cause a lot of anxiety and extra scans and sometimes biopsies along the way. Lung cancer screening can save lives, but the financial cost of the scans isn't the only cost.

-Dr. West

Reply # - July 6, 2013, 09:27 PM

catnapt
Posts: 22

Oh yes, I hope you don't think I'm making light of that, not at all.
And I did search screening when I first found this site but kept getting a blank screen. I was finally able to find it via a link in someone's post.

If I recall correctly, the results to the research study I found roughly ten years ago mentioned how early screening was leading to more tests and biopsies and that at least at that time, there was no benefit but actually a greater risk, from the screening CTs vs waiting til a person had symptoms. There was also some mention of lung cancers being found incidentally on autopsies; that people could live with undiagnosed asymptomatic lung cancers that grew very slowly and had no impact on their lives whatsoever, and end up dying from something else.

So, no I'm not making light of that information. It's just surprising to me that when I first read about that, I thought, well, now I know not to be so worried. And if anything does show up, don't automatically think the worst.

and yet here I am, some years later, with the same information but with an "actual" "potential" threat, and my mind goes to the worst case scenario.
And even though there's very little in the way of a genetic risk, having parents with lung cancer suddenly seems horribly ominous.

Just amused & frustrated with myself, that I can know that something's probably "nothing" but still have it scare the dickens out of me.

Reply # - July 7, 2013, 05:48 AM

catdander
Posts:

catnapt, we all understand the worries of lung cancer so don't apologise. Know too you are well on the way to catching anything early (big if) so that may help ease your worries; not to mention the everyday things we all live through that Dr. West suggested.

The reason you're not getting search results stems from the type of browser you're using. Some or all versions of explorer won't give you search results unless you log off first. I switched to safari and really liked it until I started having issues with the google spreadsheets used by the moderators so I moved to google chrome which does a lousy job keeping up with drafting posts. Now I keep my ms office clipboard open and use it often. I'm on a rant aren't I? sorry. I wish the industry would play nice but they remind me of a group of opinionated 6 year old girls who haven't learned to play together.

these are threads tagged with "screening", http://cancergrace.org/lung/tag/ct-screening/

this is result to search "screening", http://cancergrace.org/search-results?q=screening

Just to know you're not alone, we have many people who ask very similar questions about lung cancer work ups. Before my husband was dx I knew next to nothing on the subject. I file these questions on this forum, http://cancergrace.org/forum/lung-thoracic-cancer/work-up-staging-of-lu…

catnapt, interesting username. I hope it's only playful and no cats were taken in the making of the name. :) ,
catdander

Reply # - July 8, 2013, 12:38 AM

catnapt
Posts: 22

Thanks for your reassurance and help with searches catdander. Hmm, another interesting user name! I'm wondering if you're allergic? or have lots of cats? I chose catnapt because of my fondness for both cats and naps. It makes me think of stealing a nap,though, and not a cat.

I found my CT report! Would you all mind if I write what the findings are?
I had requested a spiral CT, but I don't know if that's what I got- it says it was a CT thorax with contrast- "multidetector":
Findings:
nonspecific 3X3 mm nodule involving right lower lobe. In addition, a confluence opacity involving the medial right lower lobe which centrally measures 10 by 11mm but does extend 4.8 cm CC and up to 2.1 cm transversely (what does CC mean??)- it goes on to say this is most consistent with scarring.
*****************
Oh I did google searches like mad when I first got this report but it only left me with more questions than answers.
In fact the original report was on my CT scan for abdominal issues- they found a 4.5mm nodule in my OTHER lung that is non existent on this second scan.

Talk about confusing!

My guess is that the opacity mentioned in both scans from when I was 18 and had a pulmonary embolism. Never had pneumonia but I know breathing was extremely difficult when I had the PE and is actually one of the factors in my fear of lung cancer- I remember vividly how awful it was to not be able to breathe fully.

That tiny nodule they see now, I bet that's where the actual clot was! OR maybe even better, this 3 mm thing isn't really there, like the one that was in the first scan. ;-)

You're right though, catdander, if, and that's a HUGE IF, this turns out to be anything to worry over, I should consider myself extremely lucky to have found it so small.

My father had no symptoms at all, his 3cm (?)squamous cell tumor was found incidentally on radiograph when they were investigating his stomach pain. He would have been lucky too, they told us, if he hadn't had the second cancer.

Reply # - July 8, 2013, 08:06 AM

catdander
Posts:

I didn't have allergies to speak of when I took the username 15ish years ago but we did have 2 elderly shedding cats. Today I have allergies, a cat, 3 dogs and lots of pet dander and I always love a good catnap. :)

From our forum guidelines, "We want brief telegraphic highlights of treatments given and how they worked, a quick summary of staging and pathology, but we ask that people not copy and paste or upload pathology reports, radiology reports, etc. It’s problematic from a confidentiality standpoint, and beyond that, we can’t practically get immersed in the extreme details of everyone’s care."
Another point I'd make is there aren't standards in the language used in reporting which makes interpreting even more a guessing game without background info. It is perfectly legitimate to ask your doctor to answer any follow up questions you have.

I paste this to let you know we aren't ignoring your specific questions. What I can say about what you've written is you got a thorough scan (thoracic area with contrast), it's very reassuring not only because the nodules are small but they are "still" small, they "look" like scarring, and there's reason to believe it is scarring (PE). Also the nodule that was gone could have been infection with the body treating itself and now gone or just a difference in spacing of the series of pics.
Your doctor may be comfortable enough to forgo further follow up or do another in 6 or 12 months.

Actually everything you've written seems pretty believable, unfortunately most lung cancer is found after it's metastasized because of lack of symptoms.

I hope all goes well from here,
Janine

Reply # - July 18, 2013, 02:24 PM

catnapt
Posts: 22

Sorry to bother you again, but I had one last (I hope!) question.

I was looking at VDT and the different rates for different kinds of LC. If I read it correctly, SCLC has a VDT of as little as 30 days.
And a 28% increase in diameter = a doubling of volume (?)

would this mean that IF the 3mm nodule found on May 30th were to grow, it would take roughly 5 mos to reach a cm, IF it were the most aggressive type of LC?

I have the option of having a repeat scan in 3 mos, 6 mos or a year. Having options is nice and all, but I don't know which to choose!!

If there's been a tiny bit of growth but not enough to be able to biopsy, then I'd just need to wait longer and have another scan. Not liking that idea at all.

Been looking around the site, and am amazed by all the information available, and everyone here is so kind.
So very sad that certain spring has passed away. It didn't feel right to post on that thread since I'd never interacted with her at all.

My mother was involved with some online support group and met the only other person in the entire US with her same diagnosis thru that group. I know it helped her a lot to have someone else who was going thru the same things.

Reply # - July 18, 2013, 02:36 PM

catdander
Posts:

Thanks for the your sympathies for our loss. certain spring was an amazing person.

I don't think we can answer the question of when you should have another CT. If you're not comfortable with 3 months then 6 seems to be the middle ground and perhaps closer to your comfort zone.

All the best,
Janine

Reply # - July 18, 2013, 02:47 PM

catnapt
Posts: 22

Yes from what I was reading, it seems she really was. But you're pretty special too. ;-)

oh, I'm sorry I wasn't more clear. I wasn't asking when I should do the repeat scan, I was asking if it was doing the math right, and if I'd understood what I read. Is the worst case scenario SCLC that has a VDT of about 30 days?

Reply # - July 18, 2013, 09:23 PM

Dr West
Posts: 4735

That's about right, but cancer can have an incredible range of biologies, so I would say that there are no absolutes about what's possible. Good luck.

I would say that SCLC is very, very rarely detected as a 3 mm nodule. Seeing SCLC as a tiny nodule is almost like catching a bullet.

-Dr. West

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