I am 41 years old, and healthy I work as a tattoo artist so I am exposed to blood/bodily fluids on a daily basis. I am a smoker and do have a family history of Lung Cancer.
I had been dealing with some symptoms that I thought were pneumonia shortness of breath and pain in the ribs/lungs coughing especially when I laid on my right side. I had been having the rib pain for the past few months progressive getting worse. The coughing started within the past few weeks I attributed it to smoking and the rib pain to a possible sports injury. I ended up at the Drs. last week last week. After a chest x-ray I was sent directly to the ER where I had a CT scan that revealed 4 liters fluid in my chest and a collapsed right lung. Radiologist drained 1.5 liters of fluid from my chest. The fluid was clear but had blood in it. After fluid was drained I was sent for another chest x-ray which revealed a large mass on my upper right lung. Fluid has been sent out for testing and I meet with an oncologist this week for results. The ER Dr. told me because the fluid had blood in it that it was most likely cancerous. The waiting is really difficult I hoping that you may be able to give me some insight as to what my diagnosis might be from this information.
Large mass found on upper lung - 1274790
gwtattoo2
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Reply # - July 25, 2016, 12:37 PM
Hello gwtattoo2,
Hello gwtattoo2,
Welcome to GRACE. I'm sorry that you have been experiencing these symptoms, and that you have received these worrisome preliminary test results. A buildup of pleural fluid can easily cause shortness of breath, pain upon breathing and rib pain, as the fluid presses upon the lungs and rib cage. Usually when the fluid has been drained, these symptoms improve.
As far as the blood in the fluid, Dr. Weiss has stated:
"There are a lot of things that can discolor pleural fluid, including infection and blood. Blood, in turn, can come from many sources, including cancer. The most important tests to evaluate why pleural fluid has changed color are the lab tests on the fluid itself. These lab tests can differentiate two broad categories of fluids, transudates and exudates. Each of these groups themselves then have many causes, amongst which lung cancer is only one. Additional tests on the fluid are then guided by these initial results. Cytology (looking at cells under microscope) can help with looking for cancer, cultures can help with looking for infection, and so on." - http://cancergrace.org/topic/cola-colored-fluid-from-lungs#post-1254996
It's good to remember that what looks like a mass on a two-dimensional chest x-ray can also represent infection or inflammation, and even with a higher-resolution CT scan, only positive biopsy/cytology results can confirm a cancer diagnosis.
I hope that you get results which indicate something other than cancer when you see the oncologist.
JimC
Forum moderator
Reply # - July 25, 2016, 01:56 PM
Thank you Jim C., obviously
Thank you Jim C., obviously they told me to expect the worst, which I have been slowly adjusting towards..I suppose for reasons that it can only be better news if the worst isn't spoken of.. I meet with the oncologist on tuesday afternoon to go through the details of the fluid.. boy the things you read in a google search just make things worse..haha.. The e.r. had said their were no specifics till the test results were looked at, and since the 1 1/2 liters were drained during that time (wednesday), I have had a much better time with breathing and haven't had the shortness of breath come back yet. when I saw my pcp the next day she told me that we shouldn't be concerned with the mass found yet. Her description was that it was near impossible to read the mass and it wasn't an accurate scan because my lung was collapsed stating it's like reading a crumpled piece of paper with words on it. I thought that was a very good analogy.. It made me feel quite relieved to hear it specified that way.. She also told me she had already assembled a team to get to the bottom of this scenario.. Again relieving some of the stress.. what should I expect to go through when I meet the oncologist?</span> will it be talking and then follow up with more appointments or are they gong to whisk me away to the emergency room? I should probably not have watched all the seasons of House on netflix.. shaking my head.. Either way thank you for making me feel a little more at ease. I don't now where else I would have turned had I not found this forum.
Reply # - July 26, 2016, 05:55 AM
Do you know the size of the
Do you know the size of the "mass?" As the primary already said, it's hard to read what's going on when the lung is collapsed. It could be pneumonia bunching up and it reads as a mass. A mass would be 3cm or larger.
Nodules/lesions are under 3cm. As hard as it is not to worry, until you have test result and the lung re-inflates for a better scan reading then you can't know what's going on. As already noted, there are other reasons for what's going on, but the waiting is the hardest part. Depending on the fluid results, there could be more tests like a PET scan. I think they'll wait until the lung re-inflates before doing more scans. Let us know how you make out. Take care, Judy
I am not a medical professional but a 2x lung cancer survivor and advocate.
Reply # - July 26, 2016, 08:38 AM
Hi gwtattoo2,
Hi gwtattoo2,
The direction of the appointment will depend on the findings from the cytology of the fluid. If cancer cells are found, then a treatment plan will be discussed. If there are sufficient cells, they may be sent for genetic testing, to see if targetable mutations are present. It's also likely that a brain MRI would be ordered, so that the presence of brain metastases can be ruled out. This is done because such metastases would take first priority in treatment.
If no cancer cells are detected, but the testing shows the presence of an infection, you will likely be referred to a pulmonologist for treatment of that infection. Finally, if no cause can be determined from the cytology, then further workup will be necessary. Unless you are in some distress, I would expect a trip to the ER.
I hope that your doctors have the wisdom of House without the terrible bedside manner!
JimC
Forum moderator
Reply # - July 28, 2016, 01:04 PM
I received a diagnosis of
I received a diagnosis of Stage 3B non-small cell lung cancer. actually my Dr. told me it was Giant Cell. I had a pet scan today 7/28/16 and will be going for Brian MRI and Bone Scan next Wed 8/3/16. They plan to start chemo next friday 8/5/16 with a cocktail of Altima, Avastin and Carbotoatin. I am in the process of scheduling a consult with Dana Farber as I am lucky to live just south of Boston, MA. What I see online about the giant cell cancer is not good. I have started coughing up bloody mucus just today and walking a few blocks thins morning I was winded and had so sit twice. I don't know what to do. I am married with two children ages 16 and 20 what should I expect moving forward and is there anything I can do to help my situation.
Reply # - July 29, 2016, 05:28 AM
Did they say which sub-type,
Did they say which sub-type, pleomorphic, sarcomatoid or sarcomatous? This is also important to know.
Going to DF for second opinion is a great idea. I went to Boston from VT for my surgery at Brigham's with
Dr. Sugarbaker, top thoracic surgeon. DF and Mass General are both excellent cancer hospitals. I wouldn't go by prognosis, as it all will depend on how your cancer responds to treatment and we're all individuals.
Since you're still waiting on other scans, you don't yet have a complete diagnosis. DF may be the one to change your treatment plan, so best to wait and see what everything turns out to be. I'll also recommend the site Inspire.com. I'm on the Lung Cancer Survivors site there and you can get lots of support. Dr. West, Jim and Janine here on GRACE can definitely help with the medical questions.
Take care, Judy
Reply # - July 29, 2016, 01:44 PM
gwtatoo2,
gwtatoo2,
You are very welcome to Grace, although I'm sure you have almost any other place you'd rather be. I'm so sorry about your diagnosis. As you know and Judy said you're lucky to have Dana Farber so near. Having a state of the art clinical research and teaching center to use as your primary or 2nd opinion so close to home will help in many ways. Use them as a primary source for treatment or as a secondary source for opinions during times of change.
It's very important to get started on the right footing/treatment decisions so I hope you're able to have your appointment with DF before getting started with treatment. There may be promising research in giant cell carcinoma of the lung that only accepts those who are treatment naive. Starting chemo before knowing all the options may not be to your advantage. However there may be reason to start sooner if it's thought that symptoms warrant. A call into DF may help if timing is a problem.
I hope you do very very well.
All best,
Janine
edit to add: The more you understand about your diagnosis the better conversation you can have with your team and the more involved you can be in treatment decisions. This is important in lung cancer care because so often there's more than one good option and your input makes a difference.