Pancoast Tumor -Please Help-Lung - 1246405

emilly
Posts:2

Please help I was diagnosed with a Pancoast Tumor , March 2012. I had 33 Radiation treatments and 2
ElsCyleclesof chemo, cisplatin/etoposide. The chemo was stopped because os severe reactions to the chemo.

Radiation continued and ended 05/11. I regained strength and gained wt. throught June. I did have continued weakening of my right hand and arm due to tumoxr invasion of the brachial plexus from the start.i had a ct done and MRI done on 4/20 to see if I qualified for surgery, but ther was no shrinkage and the
Tumor was still attached to the brachial plexus, so I was not a candidate.

Starting at the beginning of July my pain had increased in my shoulder and upper arm and hand,which was explained, in detail to my onocologist and radiation oncologist at appoinments, with both, on 07/10. This is when I had my first CT done to check for growth and spreading. I was told tumor was stable with no growth. I went to my pain ngt doctor to discuss possible change on meds and am now being sent for an MRI to see if there is forger growth n te brachial plexus. How can this change to possible growth in 3weeks. I questioned all 3octors and did not get any solid answers. Can a ct be that wrong, If so, why arn't MRI 's used to monitor instead of CT. Has this napped to anyone else. So confused. Please let me know. Thank you so much

Emily

Forums

Dr West
Posts: 4735

Emily,

Progressing pain in someone with cancer is always a concern, since it may be a manifestation of the cancer progressing. You're right that you'd expect to see progression on a chest CT, but sometimes when there are many other structures nearby, it can be difficult to assess for subtle changes in size.

An MRI may show progression that was missed by the CT, in part because it will focus on a slightly different area that may be higher yield, in light of your specific symptoms.

I do hope that there's another explanation, but either way, the study should provide answers or, better yet, more reassurance. I also sincerely hope that your pain can be managed and that you're more comfortable soon.

Good luck.

-Dr. West

catdander
Posts:

Emily,Welcome to Grace. I'm very sorry you're going through this, I think you can get the answers you need here. Pancoast tumors aren't very common, as you can see from my signature my husband also had a pancoast tumor.
It sounds like you have an idea how they are different than a primary tumor that stays in the lung. Usually a CT is enough to follow lung cancer but when there is nerves or other structures (such a bracial plexus, that need to be analyzed they will use an MRI. It sounds like a pretty normal route of following your situation. My husband had a very similar course of scans with the mri to look at the bracial plexus after chemo.
Are you taking a drug such as lyrica or gabapentin? When my husband added lyrica to his pain management it made a big difference.

As far as how well treatment works or how slowly or fast a cancer grows it depends on the individual. I'll paste a link below that may help you better understand. The search feature is quite usable for finding additional information as well as info menus across the top of the page and FAQs on the right column.

I don't know that "Pancoast tumor" info is what you need so much but here a a list of good blogs and transcripts and audio to some very good info on them.
http://cancergrace.org/lung/category/lung-cancer/special-populations-in…

http://cancergrace.org/forums/index.php?topic=4338.0

This is a good into to lung cancer http://cancergrace.org/lung/2010/04/05/an-introduction-to-lung-cancer/

emilly
Posts: 2

Thank you so much for your quick response. MRI is scheduled for tommorow. I completely agree, regarding
more detail an MRI could provide. I don't understand why it was not ordered on 07/10 by my oncologist or
Radiation oncologist. My radiation oncologist felt the pain was scar tissue forming in the area and my oncologist thought the pain was a natural progression of brachial plexus nerve damage caused by tumor/radiation and both suggested a continued 3month ct monitoring. Pain described to my pain mgt. doctor was identical.

I will have to see how tomorrow goes and possible request an MRI instead. I will also ave to find out, f there is further infiltration, what is the next course of action.

Again, thanks so much.

Emily