Hi everyone, I am new to this support site and was hoping to find some experience, strength and hope here among others with cancer and families struggling to understand and help.
My husband Tim was recently diagnosed with lung cancer in his RUL (24mm spiculated nodule). The CT needle biopsy was neg but they only got one core sample and the CT surgeon said there was probably a sampling error at the biopsy site. Clinically he feels its cancer. Following a pet scan which showed the mass and two lymph nodes on the same side as "hot", Tim had an EBUS 4 days ago. The preliminary report showed no cancer in the lymph nodes and the CT surgeon said they could be calcified lymph nodes. He said he also saw "something" on his bronchus. Then we got the "nothing is final until we get the final report" disclaimer.
My question is this: is anyone familiar with calcified lymph nodes being associated with lung ca? My husband is 54 years old. Also, since we now have 2 (tentative) negative biopsys, dare I hope? The surgeon said clinically the mass is cancer but I am wondering now.
I appreciate any input. We are lost and scared and in the waiting and worrying phase. Or is it a phase? Thank you, Shelia
Reply # - January 1, 2014, 12:50 PM
Reply To: Calcified lymph node or Cancer
Hi Shelia,
Welcome to GRACE. I hope that we can assist you with your questions at this time of uncertainty, which many of us here know to be difficult.
Whether a nodule is calcified is not always an indication of cancer. Dr. Pinder had this to say about calcification:
“Calcifications are pretty common in lymph nodes in the chest (and elsewhere) and can occur as a result of prior infections, inflammation, scar tissue, and in some cases, cancer. The calcium itself does not cause the PET to light up but the underlying cause of the calcification can.” – http://cancergrace.org/forums/index.php?topic=5528.msg35742#msg35742
The negative biopsies are a positive factor, but as your husband's doctor said, it is possible to miss the cancer cells with a limited amount of tissue available. Although it is a hard thing to do, please try to stay positive and wait for the final report. If that is not determinative, then his doctor will recommend further procedures to make a diagnosis.
Good luck with the results. Please let us know if you have further questions.
JimC
Forum moderator
Reply # - January 1, 2014, 02:16 PM
Reply To: Calcified lymph node or Cancer
I think the challenge is that if the final report doesn't show cancer, it's not possible to say definitively that there isn't cancer. Instead, we can only say that the biopsy doesn't show cancer. In other words, even two negative biopsies could still represent a "sampling error", so the negative finding of cancer may be a "false negative" (though of course it may well be a true negative and there is no cancer, which would be ideal).
Remember that even if there is actually cancer, the goal of treatment here is curative, and that is a very real probability of cure after surgery if it's an early stage cancer.
If you have ongoing doubts about whether any further intervention is appropriate after two negative biopsies but an arguably worrisome scan, it's very reasonable to seek a second opinion to help shape whether that person, ideally with an expertise in lung cancer, would recommend surgery or yet another biopsy vs. stepping back and just following scans for a while.
Good luck.
-Dr. West
Reply # - January 7, 2014, 01:30 PM
Reply To: Calcified lymph node or Cancer
Hello Shelia,
Just wanted to say hello and wish you and your husband much luck. My husband went through a similar ordeal. His scans showed bone destruction so cancer ranked # 1, 2, and 3 in possible reasons for PET results. Still I held out hope (there's always hope for something). My husband had an open thoracotomy for diagnosis after 2 CT guided biopsies and VATs. The one thing I wish I'd understood then and we'd done differently was seek a 2nd opinion from a surgeon who specialized in thoracic lung surgery. I fear the ongoing nerve pain reaching from incision to chest tubes is one to his biggest pain issues because the surgeon specialized in heart surgery not lung.
I hope I've not overstep my bounds but I've been there and remains the only thing I regret in our decision making in these 4+ years.
All best,
Janine
Reply # - January 8, 2014, 11:31 AM
Reply To: Calcified lymph node or Cancer
Thank you all so much for your replies. Your strength, hope and experience have been a Godsend. Tim and I have an appointment with his CT surgeon in the morning to go over the EBUS results and to schedule surgery. Hopefully I will have more useful info after that. It seems we do more waiting(and worrying) than anything else. His abnormal chest X-Ray was Nov 15,2013 and we still don't have a diagnosis.
Janine thank you so much for sharing your story with us. It really does help to hear that others have gone through this. I'm afraid I have been trying to talk myself into believing this really isn't cancer at all but a nasty infection. Having so little information really encourages this. I have looked for similar experiences online but haven't found any, so your story really kind of made this real. I am praying for you and your husband. God bless. Shelia
Reply # - January 12, 2014, 01:56 PM
Reply To: Calcified lymph node or Cancer
Hi Shelia and Tim,
I just want to encourage you to continue to ask questions and not necessarily stop when you get the answers you want. . . .
2 years ago, I was told a lung nodule, discovered earlier by accident, might be growing. A PET/CT did not clarify the issue. So, with encouragement from my internist (and discouragement from my pulmonary surgeon), I had thoracic surgery. The surgeon found there were actually two growths, on top of each other, in two different right lung lobes. He removed them but left the lobes since the preliminary report was just fibrotic (scar) tissue. The final pathology report was also just fibrotic tissue. I had no more respiratory symptoms and no later CT's.
That is, until late October, 2013, when I suddenly had major breathing difficulties. A flat x-ray suggested interstitial lung disease. A CT scan showed widespread nodules in both lungs with the largest seemingly located in exactly the same area where I had the surgery two years earlier. (Also, a pulmonary embolism, pleural effusion, pericardial edema, etc., besides the visible supraclavicular lymph nodes.) Hindsight, of course, is great. But I wish now that I had not been so complacent regarding the path reports 2 years ago and had requested a follow up CT, perhaps 6-12 months later.
I'm glad to hear that you and your doctor are remaining sceptical for now.
Best wishes to you both,
Shalla