Hi, Last Feb'2015 on a CAT scan a lung nodule was found on my husband right mid lobe plueral based lung it measure 0.9 x 0.6 cm, he had a PET Scan and it was clear. In May'15 he had another scan and the nodule measure 1.1 X 0.6 cm. He just had another scan and it measure 1.4 X 0.7 cm. The report states that it partically within the right pericardial fat??Grossly unchanged lingular plueral based nodule versus plueral scarring/thickening
The pulmonlogist recommended we see a thoracic surgeon to either have a biopsy or surgery to remove the nodule. My husband has smoke for over 45 years and has only recently quit (6 months smoke free).
He has a strong family of cancer 1 sister ovarian, 2 sisters uterine, 1 sister pancres, and 1 colon. Only one sister has lived past a year of diagnosis.
Should he just go and get it taken out to be on the safe side or do the biopsy and await the results?
He also has serve damage to his lungs from smoking but it has not effected his physical abilities or lifestyle yet. He is 66 years old.
I have an appointment with a thoracic surgeon for him next Friday. I want to be prepared with the right questions.... Thanks
Reply # - September 4, 2016, 07:19 AM
Hi ellen,
Hi ellen,
I'm sorry that this nodule continues to cause concern. In general, when you have some suspicion that a nodule might be cancer, but it's not clearly so, you'd like to choose the least invasive procedure available. This may be especially true since your husband has significant damage to his lungs. So I think the main question for the surgeon centers around the difference in procedures to remove or just biopsy the nodule - how invasive and how difficult for your husband. That may depend on the specific location of the nodule. There is also the question of the likelihood of success if it's only a biopsy - will it be likely to produce enough tissue to provide a definitive answer, or would you be left with the possibility of a false negative?
I hope you have a good meeting with the surgeon, and that it leads to results that can help put your fears to rest.
JimC
Forum moderator
Reply # - September 4, 2016, 09:21 AM
Hi,
Hi,
Thank you for the reply. You are thinking all the things I am thinking. I know I have to wait....till Friday. I am just wondering. Was the nodule growing to 1.4 cause for great concern. The report said it was suspicious.
If my husband lungs are bad wouldn't they be worse in 6 months/year time if the nodule got bigger? Wouldn't it be better to take it out now? There are so many questions.
What is the point of going through a biopsy and not getting an answer and still have to follow the nodule every 3 months? Why not wait and see?
These thoughts are racing in my head. Thanks for answering back. I must sound crazy......
Reply # - September 4, 2016, 09:53 AM
Hi ellen,
Hi ellen,
First of all, you're not crazy. One of the worst things about a cancer diagnosis or suspicion of cancer is the uncertainty it causes. You can call it crazy but it's a perfectly reasonable reaction to the situation.
The growth over the past year has not been excessive, and some of the difference in dimensions could be attributed to a difference in scanners or the way the nodule was measured. So it may be reasonable to wait and see. The nodule is not large in size, so even if it grows a bit in 6 months, it may not affect his overall lung status, depending on where the nodule is located.
Just make a list of all your questions/concerns and bring it to the appointment, so you won't forget anything.
JimC
Forum moderator
Reply # - September 4, 2016, 10:05 AM
Thank you for such reassuring
Thank you for such reassuring words!
Reply # - September 7, 2016, 02:35 AM
Hi Jim, I spoke to the
Hi Jim, I spoke to the pulmonlogist yesterday. I asked him what type of a procedure my husband would need. He said it would be VATS due to it's location and sometime needle biopsy can give you a false negative. I have two appointments lined up one with the doctor's referral at White Plains Hospital, one at Columbia Presbyterian and I am doing all the paperwork to get us appointment at Sloan.
My question is this... about how long is it from the time a patient decides to have surgery.... and the time they have surgery? Does it usually take about a month to do all the testing and paperwork prior? Just wondering.
For me the worse thing is not having an idea to map out a plan. Thanks so much.
Ellen
Reply # - September 7, 2016, 12:48 PM
Hi Ellen,
Hi Ellen,
It sounds like you're really putting things together well. I know how long and drawn out all this seems but 4 weeks is good timing. There's a blog I'll look for that looks at the timing to treatment and what was found is even the slowest systems found no decline in outcomes; 144 days stands out in my mind.
Scheduling surgery depends a lot on the surgeon's schedule. The most important part on your end is to know the surgeon is an experienced and dedicated thoracic surgeon.
All best,
Janine
Reply # - September 7, 2016, 01:07 PM
Here it is.
Here it is.
In expressing his understanding of stress caused by the waiting Dr. Pennell said, "Even 45 days seems like an inordinate time to wait between that first scan and treatment, but I think I would have a conniption if I or someone I cared about had to wait 76 days or 140 days!" http://cancergrace.org/lung/2009/11/06/delays-in-treatment-for-lung-can…
He goes on to explain, "Perhaps surprisingly, it turns out there was no significant difference in survival between the patients who had longer image-treatment intervals and those who waited a shorter time."
The waiting really is the hardest part and getting a plan in place is part of all that. Many people have written on Grace about the stress related to the lack of a plan in place.
I'll wait for good news as you help your husband move through the process.
Reply # - September 8, 2016, 05:04 AM
Did the pulmonologist suggest
Did the pulmonologist suggest a pulmonary function test? These are always done before even considering surgery. I don't really see much growth in a year and a half and as Jim already said, what might be considered growth could just be the cut of the scanner. Has he had a PET scan?
Take care, Judy
I am not a medical professional but a two time LC survivor and advocate.
Reply # - September 8, 2016, 10:07 AM
Judy and Jim are right and
Judy and Jim are right and hopefully part of the second opinion done at Sloan is to determine if a biopsy is even necessary. Even the lest invasive procedures carry risks and a VATS is quite invasive even if it's considered much easier than an open thoracotomy; that's because an open thoracotomy is extreme for any reason.