Dr. West,
It has been a very long time since we have spoken.
LUL in mid 2005 of less than 2 cm. lesion -- was BAC
Resection of less than 2 cm. lesion in mid 2008.in R lower lobe ... bac with adenoma
It's been so very long I have a difficult time remembering everything but I know you were my guiding light then and will be now. I did go to Yale back then for a second opinion..... I.live in upstate NY.......and my doctor knew of your site and read your posts regularly. His prognosis and treatment decisions were to do nothing after the second resection, just as you said Dr. West.
My cat scan picked up a 1.3 lesion upper right low edge of lobe. I have not had a Pet yet although it was scheduled several weeks ago as my son passed unexpectedly and I am just now trying to get back to personal business. One thing I am wondering is if there is any new type of surgery perhaps to remove this lesion because I was told pretty much five years ago that surgery would probably not be possible again as I Have COPD. Of course, I am thinking too that perhaps this isn't a full BAC lesion, or even partially, but maybe something else. Could this happen too, like maybe its now just an adenocarcinoma alone..
Joyce
Reply # - April 26, 2013, 09:11 AM
Reply To: BAC BACK …BUT THOUGHT I SAID MY FINAL GOODBYS 5 YRS.
I'm very sorry to hear about your son's passing, as well as the new lesion, though of course I'm glad you've done so well for so long. Presuming that it's confirmed as a cancer, two options that would involve less extensive loss of lung tissue than a lobectomy would be either stereotactic body radiation therapy (SBRT), which has become much more widely used over the past 3-5 years and has looked very favorable as an alternative to surgery for people who can't safely pursue surgery or perhaps just don't want to, or else a wedge resection, which may be feasible to remove just the area of lung around the nodule itself.
Good luck.
-Dr. West
Reply # - April 26, 2013, 09:28 AM
Reply To: BAC BACK …BUT THOUGHT I SAID MY FINAL GOODBYS 5 YRS.
Hello Joyce, It seems totally inappropriate to welcome you back, but that's what I'm doing. I can't say how sorry I am about the devastating blow of loosing your son. Please accept my condolences.
Dr. West will surely respond within the day as he has done in the past. We have a couple of moderators now that help field the more common questions, point some towards links in our fab library, and act as receptionist. Fancy right? (Edit to say Dr. West replied while writing this post.)
I don't know if you know this or not but this may not be cancer. It could be infection or inflammation.
If it is cancer I doubt a surgery would be a first option especially with COPD and one or 2? other resections. But there have been other treatment/no treatment advancements. I'll leave you with some reading material,
http://cancergrace.org/lung/2013/01/20/mf-bac-algorithm/
This is an overview of molecular markers, genetic testing, I don't know if you were tested for EGFR mutation?
http://cancergrace.org/lung/2010/10/10/overview-of-molecular-markers-in…
http://cancergrace.org/lung/2013/02/22/sequist-molec-testing-nsclc/
I hope this is just an ugly scare,
Janine
forum moderator
Reply # - July 25, 2013, 09:52 AM
Reply To: BAC BACK …BUT THOUGHT I SAID MY FINAL GOODBYS 5 YRS.
Hello Dr. West,
My pet scan of the 1.1 x 1.3 nodule reported no significant fdg value...max 2.5.. But it is a spiculated nodule located in right upper lobe, altho centrally located which my other nodules were peripheral. My oncologist said he does not know of any reason the fdg value would be insignificant if it was cancer. Also reported on the pet was a 10mm left cervical node in zone 2 not changed since last pet scan two years ago. suv is 6.8 and is worrisome for neoplastic process. He recommends another cat scan next month.
I have been on prednisone since Jan. 2013 due to optic nerve hemorrhages which have ceased and am tapering off now slowly. Could this affect an fdg reading, Dr. West, and is neoplastic disease related to lung cancer ?
Have a wonderful weekend.
Joyce
Reply # - July 25, 2013, 12:26 PM
Reply To: BAC BACK …BUT THOUGHT I SAID MY FINAL GOODBYS 5 YRS.
Hi korusgirl, I'm sorry you're back with more info worrisome for cancer. Neoplastic is a term used for abnormal cell growth and can be benign or malignant which is probably why the doctor wants a CT next month. However it could be infection or inflammation it's very difficult to know and why keeping a close eye on it is important.
I'll ask a doctor to comment.
I hope this is not cancer.
Janine
Reply # - July 25, 2013, 12:53 PM
Reply To: BAC BACK …BUT THOUGHT I SAID MY FINAL GOODBYS 5 YRS.
Hello. Dr. Evans here. The report of your PET/CT is not exactly straight forward. So "neoplastic process" does mean abnormal cell growth and usually means the concern is for cancer. So by PET criteria, the left cervical node is concerning for a potential cancer because the node "lights up" rather brightly (the usual cut off on a PET scan for the SUV value concerning for potential cancer is greater than 2.5). However, the size of the lymph node (10mm) is certainly within the range of normal for a lymph node (enlarged nodes are usually more concerning for cancer). The biggest argument AGAINST this being cancer, however, is if this node truly has not changed from the PET/CT scan two years ago. So, given that, I think follow up with imaging is reasonable, though neck nodes are usually not difficult to biopsy.
The low SUV value of 2.5 on the lung nodule is reassuring, but unfortunately does not absolutely mean the nodule is not cancer, particularly if the nodule has shown growth over time. Sometimes smaller nodules (generally around 1 cm or less) may not "light up" on PET/CT even if they are cancer, and BAC's are less likely to light up on PET/CT. Therefore, I agree that this nodule should be followed. Unfortunately, these small lung nodules, particularly when central, can be quite difficult to biopsy. So follow up CT scan is appropriate.
As far as the prednisone, should not affect the FDG readings (unless maybe if the prednisone is causing your blood sugar to be elevated, though I still doubt this would substantially affect above interpretation.)
Hope this helps.
Reply # - July 25, 2013, 07:11 PM
Reply To: BAC BACK …BUT THOUGHT I SAID MY FINAL GOODBYS 5 YRS.
I agree with Dr. Evans, a lung cancer expert I've known since we were in training together in Boston.
It's not possible for us to interpret the PET, because as she notes, it's not straightforward. But any areas with abnormal PET uptake are concerning for being potentially if not likely involved with cancer. The key issue with a relatively low SUV is that the lower range is where there is a very significant overlap between relatively slow-growing cancers and non-cancer causes for uptake, such as inflammation or infection. But any changing/growing areas with PET uptake warrant further evaluation.
Good luck.
-Dr. West
Reply # - January 4, 2015, 05:55 PM
Hello Dr. West,
Hello Dr. West,
When last I wrote In 7-13 and your responses, I guess I truly wasn't looking for a way to take care of the new tumor nor the parotid lymph node problem. Very distraught with my son's death, I needed to grieve and needed help.
I've had two cancers removed surgically with no other follow up. In mid 2005 I had an LUL removed about 2 cm. It was BAC. In mid 2008 I had a resection in the RLL of less than a bit over a cm It was Bac and adeno.
In March 2013, a 1.5 x 1.3 nodule SUB 2.5 was discovered in the RUL apex. Together with a 10mm lymph node in zone 2 of the medial portion of the parotid gland with SUV of 6.8 up from in 6.3 in 2009. I have had SUV uptake in the parotid area for years, beginning in 2007 when it was a 2.2 SUV.Several times there was no SUV pickup so it was felt it was inflammatory. This was when I wrote to you.
In October 2014, I felt a lump in my neck on the left side. I went to my GP and a cat scan revealed three heterogenous soft tissue nodules. One was 17 x 11 x 2.5mm. Second was 11 x 11 x 1.2mm and no description was given for the third but they were adjacent to the sternomastoid muscle. (sp?) Subsequent Cat/Pet said they were 7.3 SUV.
The cat/pet reported the right upper apex nodule at 1.6 x.1.5 with a 6.5 SUV in addition to hilar lymph on right at 7.8. I have never had lymph nodes involved, this is a first. The rise in the SUV is phenomenal too although there is almost no growth in the right lung nodule.
In November 2014 I had a tissue lung biopsy which said it was adenocarcinoma well differentiated. acinar growth, chronic inflammation and fibrosis. No vascular invasion. TTF-1 is positive.
I had a neck biopsy done in the office and it came back undiagnosable. I have seen my surgeon who perfomed my other surgery and wants to remove the node soon. He said my pulmonary function is fair to good and he was very surprised. I am 73. My questions are several, Dr. West. OOPS next post.
Reply # - January 4, 2015, 06:05 PM
Dr. this will be brief. sorry
Dr. this will be brief. sorry. I'm guessing I need to have that neck biopsy now to see if it is related to the lung carcinoma or not before I can decide what to do. My surgeon wants to move ahead and at my appointment with my oncologist he said radiation could be done with good results to the hilar lymph node and the carcinoma node together with chemotherapy, hopefully tarceva.. He noted my age as being an issue. Chemo and radiation are all foreign to me.
To make this a mystery, I have lost about 40 lbs. in maybe 2 years. Grieving and stomach problems may have added to that but I didnt think I ate less. So it's frightening me to think that I might be metastatic now although the full body pet scans show nothig else.
Thank you for your input, Dr. West
Joyce
Reply # - January 4, 2015, 10:05 PM
First, I'd say that this is
First, I'd say that this is not BAC. BAC often co-exists with more common adenocarcinoma, and a cancer that involves the lymph nodes and has an SUV in the 5-10 is not BAC. My impression is that your past history is essentially irrelevant here and that it would make the most sense to approach your case as if everything here is a separate, new cancer.
Based on the location of some of the nodules, I'm not sure surgery makes sense, so it might be helpful to get some additional opinions. However, I would not let your age of 73 be a guiding or limiting issue. The median age of a new diagnosis of lung cancer, in the US at least, is 71, so you're barely above average, and the clear preponderance of evidence supports NOT limiting fit elderly patients based on age, especially when that's under 75 or so. It makes more sense to make decisions based on additional medical problems and overall frailty rather than age as the leading driver.
Good luck.
-Dr. West
Reply # - January 5, 2015, 05:07 AM
Great to hear from you once
Great to hear from you once more, Dr. West.......having my morning coffee and finding that you had already answered me, made my heart take wing. Do you sleep? :)
Regarding the neck nodes, my oncologist, surgeon and ENT surgeon do not feel that they are related to the lung nodule. Will a tissue biopsy answer this question, Dr. West? And if they are the same as the lung cancer, that would mean that surgery is not an option, right?. One of them said it could be Warthrin's tumors.
Also, the tissue lung biopsy mentioned positive for TTF-1. I just looked it up in the ACP website and it mentions other tests, such as EGFR, KRAS and possibly then ALK should be done on biopsies as well. Should I request my oncologist have these tests performed?
Mentally I am still 25! :) Skipping along with never an obstacle, but my back keeps whispering "no, no" !
Bless You,
Joyce
Reply # - January 5, 2015, 07:43 AM
Hi Joyce,
Hi Joyce,
A tissue biopsy could certainly resolve the question of whether the nodes represent lung cancer, although not all biopsy results are determinative...false negatives can occur.
As Dr. West said, the location of some of the nodes suggests surgery may not be the best choice, and a determination that they are from your lung cancer only strengthens the case against that. But you will need to discuss that option with your medical team to hear their reasoning. Cancer treatment often is tailored to the individual, and in such cases norms may be disregarded.
Molecular testing for EGFR and KRAS mutations and ALK rearrangements is often recommended for most lung cancer patients, although they are much less likely to appear in patients with a significant smoking history.
I hope that with the help of your doctors you can choose a good treatment plan, and that it is effective for you.
JimC
Forum moderator
Reply # - January 5, 2015, 12:57 PM
Thanks so much for getting
Thanks so much for getting back to me so quickly. I appreciate your dedication more than you can ever know..
The thing that is making me extremely anxious more than anything else is the weight loss I've had. About 40 or more lbs. in the last two years.....I am not sure because I dont weighh myself and only realized it about 5 months ago when I felt my knuckles for the first time in a very long time. :)
So I am fearful that I have some metastasis that is causing me to loose weight altho the pet scans I have had show only the lung nodule which hasnt really grown in almost two years, a hilar lymph node and then these neck lymph nodes which have appeared. Could you explain to me a bit if the weight loss is metastasis could it be in the blood or the lymph nodes or what and can it be seen by any type of lab work? I aske my oncologist an he said he was baffled after checkig my cbc, red and white cells, etc. from my lab work.
Thank you again,
Joyce
Reply # - January 5, 2015, 02:36 PM
Have you had a thyroid test?
Have you had a thyroid test? IMHO, if it were me, I'd want the neck nodes biopsied. Maybe getting a second opinion would be a good idea. Take care, Judy
Not a medical professional. I'm a NSCLC survivor.
Reply # - January 5, 2015, 03:36 PM
Whether cancer or not the
Whether cancer or not the neck nodules could either involve or push on the thyroid causing metabolic problems. But just going through the stresses of your last 2 years causes many people problems with eating.
But let's see what the experts have to say.
The best of luck,
Janine
Reply # - January 5, 2015, 06:01 PM
Dear Joyce
Dear Joyce
a lot of your questions have already been tackled by Dr West and others, so I will try to limit my comments to your weight loss question, which seems to be: can you have lost 40 lbs in the last two years due to some cancer that is hiding in the bones or other places not picked up on the PET? i hope this is what you are asking.
The easy answer is, I don't think so. PET scans are pretty good at picking up cancer, in the bones and elsewhere so it doesn't sound likely that anything is hiding. It does sound like you need some further clarification about your cancer and a core biopsy would be very helpful, molecular tests such as EGFR can be done later once the primary cancer is identified. But i was going to focus on the question of weight loss....
Many things can contribute to weight loss, certainly sounds like stress has been a major factor in your life in the last few years and that can effect your appetite and generally cause weight loss. Grief and worry can have similar effects. As others mentioned we definitely would want to look for any other causes - checking your thyroid hormone is a great suggestion, a screen for diabetes and a test of your general protein level and liver function would all be easy things to look for on blood tests. If you were a smoker and have COPD that can also cause weight loss over time. And definitely cancer itself can cause one to lose weight, but I don't think it means that the cancer is hiding other than where the PET located it.
Dieticians and nutritionists are good people to talk to about this. We usually want our cancer patients to eat well and maintain their weight so in general i suggest high protein, high calorie diets with a good balance of protein, vegetables and fruits. Of course a diet does depend on each person's health and any other medical conditions they may have.
Hope that helps, best of luck
Dr Laskin
Reply # - January 6, 2015, 07:31 AM
Oh yes, Dr. Laskin, you have
Oh yes, Dr. Laskin, you have answered my weight question thoroughly. I feel I now have a direction to look into and am baffled as to why my oncologist didn't recommend this at my appointment with him two weeks ago. I am going to have these tests as you suggest and see what shows up. Happy New Year to you and yours!
Joyce
Reply # - February 12, 2015, 12:12 PM
Hello again, Dr. West and Dr.
Hello again, Dr. West and Dr. Laskin,
My weight loss is still controversial as I had mucho labwork performed and all came back OK.
A second core biopsy of my neck nodes also came back benign.
That was wonderful news to me as I was anxious thee cancer spread from my lung to my neck. Now my surgeon is recommending a resection of the 1.4 adeno nodule in the right apex lung and removal of lymph nodes.
This is my third small nodule in ten years beginning in 2005 with an left upper lobectomy of BAC. Followed by a resection of lower right lobe in 2008. That was an adeno, bac mixture.
There was never lymph involvement in the cancer nor have I ever had any other treatment.
The node I have now was described as well differentiated, spiculated. My question is how can a pathologist tell if a biopsy of just a tiny piece of tissue is well diferentiated since I thought that had to do with the margins of the tumor.
Also, I am 73 and extremely anxious about another surgery but thankfully my heart is good and even with COPD they say my lungs are too. I wa reading on your site about VAT surgery and wonder if this would be easier on my body My surgeon does not perform VATS so I would have to get another. Is it that much less. trauma to the body
Thank you All,
Joyce
Reply # - February 12, 2015, 12:47 PM
Hi Joyce,
Hi Joyce,
VATS surgery is much less intense on the body with an average shorter recovery time though it's not always an option depending on where the tumor is. You seem to understand the indolent nature of you disease by asking whether or not surgery is really needed at this time, an excellent question. If your surgeon doesn't offer VATS it's very likely your not being seen at a major cancer institute or research hospital. It may be time to seek out a second opinion at a large teaching hospital where BAC and indolent lung cancer is seen often and treated with a less is sometimes more approach.
Well differentiated refers to how the cancer cells look. So it's very appropriate for the pathologist to make that determination. Dr. West explains like this, "What do we mean by differentiation? The degree of differentiation of a tumor is how much it looks like normal, non-mutant lung cells. Well differentiated lung cancers are pretty close to normal appearing, while poorly and undifferentiated lung cancers look completely wild, not like the cell they originated from." http://cancergrace.org/lung/2007/03/20/tumor-grade-and-prognosis-in-nsc…
I hope this is helpful. All best,
Janine
Reply # - February 12, 2015, 01:50 PM
I had an "Ohhh" moment
I had an "Ohhh" moment reading the meaning of cell "differentiation"! Thank you so very much! I thought I knew. LOL
Albany Medical Center is the Hospital I use and you're right in that it is a teaching hospital, and no research.. My surgeon is one of many in the cardio-thoracic group so I will contact them tomorrow to find out if any do perform VAT's surgery. Are lymph nodes removed in VATS surgery at the same time the nodule is removed or is that a different procedure.
Thanks very much for your help, Janine.
God Bless,
Joyce
Reply # - February 12, 2015, 09:27 PM
Hi Joyce,
Hi Joyce,
Yes, lymph nodes can be removed in the same procedure. You may find this post (in pdf format) on VATS helpful.
JimC
Forum moderator
Reply # - July 16, 2015, 06:09 AM
Hello Dr. West,
Hello Dr. West,
My third nodule in more than ten years was removed via VATS surgery this past March from the upper right edge of my lung. Previous two pet/cat scans revealed a hilar node of 7.8 and then 6.5. right before surgery. My surgeon at AMC in Albany, NY was going to do a regular resection, until I said I wanted Vats. My biggest failure in life is that I assume too any things. I assumed the hilar node would have been removed. I just had a pet/cat scan which gave an 8.3 reading on the node and said there are two other smaller ones about 4.0 SUV.---high suspicious of mets.
I asked my surgeon why he did not remove it at my appointment yesterday and he said he doesn't do that during VATS resection. I said why can't we do another VATS surgery and take the hilar nodes out? He suggested a bronchoscopy for diagnosis followed by chemo or radiation.
Later in the day I saw my oncologist who said lymph should have been removed...he said that right after my surgery as well but since I did so well and felt great, I discarded the thought. Can you see the large question mark sticking out of my forehead right now?
The node that was removed was a bit less than 2 cm as my other two were. The earlier nodules ere dx. as BAC but this one was an adenocarcnoma, well defined and staged T1NXMO. But of course, this is incorrect, now that I've read up on the staging, as there was mets to the lymph nodes I guess.
I don't know what to do next, I'm so confused and feel a bit deceived at this point. Can you help straighten my thoughts out and give me some direction as to where my next step should be. My oncologist suggested radiation, but the surgeon said chemo. Help!
Reply # - July 16, 2015, 06:12 AM
Dr. West,
Dr. West,
Forgot to mention that I have never had any chemo or radiation for my other nodules.
Thank you,
Joyce
Reply # - July 16, 2015, 10:16 AM
Just wanted to say that
Just wanted to say that before my surgery I had a mediastinoscopy to check my lymph nodes. If any had been found then the surgery would not have been done. Thankfully for me, I had no lymph node involvement.
It doesn't sound like your surgeon is a dedicated lung cancer surgeon but a cardio/ thoracic surgeon. I sat down with my surgeon and we discussed every part of the surgery. He is also the one who did my mediastinoscopy first. It's sad those lymph nodes and others weren't removed and tested during the surgery but it's too late to do anything about that now. Are the recommending chemo and radiation? This would be from your onc not the surgeon. Wishing you the best. Take care, Judy
P.S. from what I've read, you're stage would be IIIB.
Reply # - July 16, 2015, 02:57 PM
Thanks so much, Judy for your
Thanks so much, Judy for your input. You are correct that I had a cardio-thoracic surgeon and since I was very happy with his previous surgery I saw no reason to question the procedure. Matter of fact, he had planned on doing a regular resection for this nodule but I saw on this site about the VATS surgery, asked if he did it and he said he did. I know now he hasn't had extensive experience. I should have had a second opinion. Altho it's late in the game already, I am seeking Dr. West's advice on what should be done right now. Thank you again, and God Bless
Joyce
Reply # - July 16, 2015, 10:14 PM
Hi Joyce,
Hi Joyce,
With such a complicated and long history with your disease it's not possible to give general thoughts about next steps. Your cancer is can be treated in many ways, radiation and chemo included. It may be time again to seed a 2nd opinion at a large research/teaching hospital with a lung cancer medical oncology specialist.
If it's thought that the cancer is metastatic radiation would only be given as a palliative tx, such as if a mass were causing pain. Otherwise chemo and other anti cancer drugs are options. If your disease is thought to be stage III radiation or possibly surgery may be given for curative purposes along with chemo. Options for stage III nsclc vary widely depending on the individual. This post is a good start to what could be involved, http://cancergrace.org/lung/2010/04/23/stage-iiia-n2-nsclc-summary-ref-…
and
http://cancergrace.org/lung/2010/08/22/introduction-to-locally-advanced…
This intro to nsclc explains staging as well as treatment decision making, http://cancergrace.org/lung/2010/04/05/an-introduction-to-lung-cancer/
I'm sorry but we aren't able to advise you on what your next step should be but we all more than willing to answer specific questions if/when you have them. Please let us know how things move forward.
Janine
Reply # - July 17, 2015, 04:25 AM
Thank you for sending me the
Thank you for sending me the articles. There is a lot to absorb. I just ran over them but know I will reread several times! Could you stage my cancer for me, 2cm adenocarcinoma removed from upper right periphery of lung with hilar node involvement....2 nodes. Thanks again.
Joyce
Reply # - July 17, 2015, 05:55 AM
Janine gave you a staging
Janine gave you a staging link so that you can look it up yourself. You had a T1 tumor since it's less than 3cm. The lymph nodes are N3 since one is the hilar node and that makes you a T1N3M0. MO means no other organs involved. And makes it stage IIIB.
Take care, Judy
P.S. I am not a moderator, just a LC patient.
Reply # - July 17, 2015, 10:20 AM
To add to Judy's excellent
To add to Judy's excellent answer, hilar node involvement needs to be considered according to where it's found. If it's on the same side as the primary tumor it is considered N1 if on the opposite side of the chest it is considered N3.
On cancer.org it's explained, "NX: Nearby lymph nodes cannot be assessed.
N0: There is no spread to nearby lymph nodes.
N1: The cancer has spread to lymph nodes within the lung and/or around the area where the bronchus enters the lung (hilar lymph nodes). Affected lymph nodes are on the same side as the primary tumor.
N2: The cancer has spread to lymph nodes around the carina (the point where the windpipe splits into the left and right bronchi) or in the space between the lungs (mediastinum). Affected lymph nodes are on the same side as the primary tumor.
N3: The cancer has spread to lymph nodes near the collarbone on either side, and/or spread to hilar or mediastinal lymph nodes on the side opposite the primary tumor." http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non…
Again I want to emphasize the importance of getting this right. No one who isn't seeing you with all the information available is able practically, ethically, or legally to stage someone. Since you have such an complicated cancer it is very appropriate to get a 2nd opinion on what and how to treat your cancer. As a layperson who has never had cancer I can only imagine the turmoil you're going through. Know we are here to help as well as we can.
All best,
Janine
Reply # - July 17, 2015, 11:32 AM
I agree with Janine that only
I agree with Janine that only your doctors can stage you. I was just giving the basics but they can be different for you. Take care, Judy
Reply # - August 30, 2015, 11:42 AM
Dr. West,
Dr. West,
Please help! I don't know what to believe regarding my lung cancer right now. I had ONE nodule and now they say I had/ two and still have One left!
Please read my July 16th posting above. I've been seen by an ustate NY teaching medical center by a cardio-thoracic surgeon for my lungs for 10 years. Until this last 1.8 nodule was removed via VATS, I had not received chemo or radiation for the prior BAC small nodules surgically removed.
There were two hilar nodes which lit up pre surgery and altho I expected them to be remove during the VAT surgeery, he did not, which lefet me with hilar nodes needing treatment. He said I should go for chemo, with a bronchoscopy first.
I went for a second opintion to thoracic oncology department at a large Ct. cancer center to find out how best to treat or removethe lymphs..
I keep copies of rcords of all my testing. During the past few years the cat scans and pet/cats have been done at different facilities and read by different radiologists.
Before the last surgery, I had been diagnosed with 1 nodule in upper right lobe.
.
The Ct. doctor viewed two pet scans. One from before my March surgeery and the other post surgery. He said,"I am so confused because there are two nodes on the pre surgery scan and one on the post surgery scan". 1 is still there,small, and about two inches more toward the center. I guess I honestly went into shock when he showed them to me and didn't hear much of anything after that.
I am having a mediastinoscopy next Tues. at Ct. and still my head is reeling. I'm do confused. I read the reports, done at different hospitals, imaging centers, etc. by diffeerent radiologists and NONE say there are two nodules. Please can you help me to understand what's happened to me.
Reply # - August 30, 2015, 01:05 PM
I think you received your
I think you received your answer from the last CT doctor to review your scans. Since Dr. West is not your doctor and has no access to your scans, he can't see what this doctor is telling you he sees. I think you'll have more answers after the mediastinoscopy to check out those lymph nodes. Is there any way to have your scans done in one place all the time? Sometimes the difference in the cut of the CT scan can cause this type of confusion. My guess on having only one node left after surgery is that is what not cancer and just resolved itself. Take care, Judy
Reply # - August 30, 2015, 01:31 PM
No, my surgeon is quite far
No, my surgeon is quite far away, my oncologist closer. Use different hospitals and imaging centers.'The Conn surgeon showed me the two lit nodules on the pre surgery scan, and the one remaining on the post surgery.
So it is mystifying. 1 pre surgery cat scan report I have also only mentions 1.
Sorry I just can't wrap my head around the fact that my surgeon and many radiologists missed this second nodule! My oncologist is out of the pictre here because he only read reports not the cd..
I'm having trouble understanding the last sentence of your reply. Could you do it again for me.
Thanks,
God Bless
Joycee
Reply # - August 30, 2015, 04:36 PM
I think Judy is saying that
I think Judy is saying that one of the nodules was never cancer, that it may have been an infection that cleared up and went away. However my understanding is one was removed and the other remains. ?
Whatever the case I'm afraid neither Dr. West nor any of our specialists can explain to you what happened. It sounds as if your doctors may be having that problem and they have all the info. If you're not happy and can't get answers from the surgeon it may be best to move on to ask for clarification from your new surgeon in Conn. Your medical oncologist should understand what's happening and may need to contact the surgeon for clarification. Another option is to see another oncologist altogether, one who specializes in nsclc. Memorial Sloan Kettering in NYC has one of the top cancer centers in the US and very likely would be able to give you answers and advice you need.
I hope you can get answers.
All best,
Janine
Reply # - August 30, 2015, 05:42 PM
Oh so no, there were never
Oh so no, there were never two nodules identtified in any cat or cat/pet scans by either the radiologists in the hospital or imaging center, or my surgeon in Albany, NY.
The Conn. lung specialist saw two and showed them to me on the pre and post surgical peet/cat scans. They did another cat scan while I was there just to be certain and there was another node in my lung.
Baffling to say the least. The docs at Conn. cancer center said well, it was more buried and diffiicult to I.D.
Huh, said I.
Im still shocked and can't yet believe it is true. My doctor at Conn. is the Chief of the Lung Cancer unit and he also said the hilar nodes are very small and he doesn't feel they are cancerous but only inflammation.
Thank you for all your assistance. I will keep on trucking and see what happens next week.
God Bless
Joyce
Reply # - August 31, 2015, 08:39 AM
Just because a nodule is seen
Just because a nodule is seen on a scan doesn't mean it's cancer. You're missing what we're saying. It's probable that one of the nodules was not cancer. This doesn't mean it can't show up on a scan. It's not only cancerous nodules that show up on scans. I'm inclined to agree with the doctor in CT about what they were, possible inflammation which can resolve on it's own. Take care, Judy
Reply # - August 31, 2015, 08:54 AM
Hi Judy,
Hi Judy,
Thanks for your input. I know that they are not always cancerous, the nodules that show up in the lungs. The cat scan I had in Conn a few weks ago showed that the other nodule was still there after I had my surgery in Albany.
What the Conn. doctor said was he didn't think the hilar lymphs were due to their size. Let you know more after I have the mediastinoscopy Tues.
God Blss
Joyce