Can't get biopsy for possible BAC unless open Surgery? - 1248328

rorwick44
Posts:2

Found on CT Scan 3 years ago many GGO. One in right lung was 9 mm on 6/5/2009 and two in left lung were both 5 mm and other GGO that were smaller in both lungs. First two years of scans no change in any. On June 8 2012 they all grew. My previous comparable scan was from June of 2010 (2 years prior). The right lung grew from 9 mm to 1.5 CM and the two in the left lung grew from 5 mm to 9 mm. The scan also said many more GGO's in both lungs. Had a bronscopy but could not get to any but took samples for TB, fungas etc. After 8 weeks all came back negative. Had many blood tests all negative. Thought about needle biopsy by Hubert Humprey Cancer Board radiogists feel they could not get to it. Had MRI brain and PET full body scan and MRI clean and PET said low uptake 1.4 of chest. My thoratic surgeon said we have to find out for sure if it is BAC so his plan is to do a open surgery , not VATS, and take out 1.5 CM in right lung and take biopsys of left lung GGO. I am thinking of just doing a 6 month wait and see. If I do the open surgery I would be out of work for weeks because I am self employed. I have not had a second opinion. I am 54 years old and have smoked for 40 years. My brother died of lung cancer at 44 and father died of pancreatic cancer at 46. Don't know if I should just wait or do the surgery to get the biopsy. With the biopsy I think I could apply for Social Security benefits so this would be a plus to the surgery.

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Dr West
Posts: 4735

I think that aside from an open surgery, it should be possible to do a wedge resection of a lesion that may need to be localized by "wire localization" beforehand, in which a CT-guided localization of the lesion under imaging guidance can leave a thin wire that the surgeon can use to find the area that needs to be removed, even if a lesion can't be visualized. This might be able to be done by another thoracic surgeon even if the one you've spoken to can't or doesn't do that.

It's certainly possible to wait and see how things go in the next six months, but if things grow by another millimeter or two, is that going to really change the options for what to do next?

-Dr. West

rorwick44
Posts: 2

Thank you for reply to my question Dr. West. I have never heard of this wire procedure you refered to. I would feel much better with a wedge instead of lobectomy. My biggest fear is losing parts of my lungs and needing it later because of progression. I will look into the wire procedure and talk to my surgeon about it. You really made me think when you said so what happens in 6 months in they have grown a bit? I don't know if I wait again 6 months or decide then to have the lobectomy. I just really want this not to be happening but it is. Part of me says just do the surgery, find out what it is, and if its cancer maybe there is a chemo to try. The other part says maybe I'll be lucky and have a very slow growing BAC and it will just grown a bit every year and not cause any symtoms for me. Since the largest one is 1.5 CM I look at other cancer patients and say to myself that mine is still small. I keep going back and forth on what is the right decision to make. I thank you again because everyone talks to highly about you in my Inquire group and recommended I ask you and now I know why. Thank you for helping all of us that really don't know what to do and are struggling.