Large ground glass opacity - 1273599

24 posts / 0 new
Last post
becktoria74
Large ground glass opacity - 1273599

I had a ct scan four months ago to verify resolution of a pulmonary embolism. Ended up talking to a pulmonologist because of a large (9x2.5cm) ground glass opacity in the lower lobe of my left lung. The radiology report said that the spot had grown from 6x2.5cm and was more ground glass in appearance. This was from a scan three years before.

I've had a bronchoscopy, which revealed nothing from pathology or cultures and am now scheduled for a surgical biopsy in two weeks.

In my reading I see lots of information about ground glass but nothing about larger opacities. Bloodwork shows nothing and I am mostly asymptomatic. My pulmonologist believes there's a small chance it is BAC but I can't find any reports of anything similar.

Any experience with what I'm looking at?

Thanks.

catdander
Hi becktoria,

Hi becktoria,

I'm sorry you're having these issues and hope it's not BAC. Though if it is it's obviously very slow moving and that's the best type of cancer to have (from a cancer perspective).

Actually what you've described would be a pretty typical appearance of BAC or something like pneumonia or TB. Perhaps when you google ggo (ground glass opacity) the topic is that of smaller sizes. In fact if it's cancer they do usually grow over time and become as large as you've described (there is quite a bit of variability in how fast that may be). Symptoms in lung cancer don't usually show up until the cancer has progressed quite a bit. Unfortunately this is the biggest problem with finding lung cancer while it's still curable.

If a ggo is found it's very possible to remove all the cancer for a cure.

Blood tests aren't useful for diagnosing lung cancer so not finding any abnormalities in the blood is typical. The biopsy should help determine what it is.

Dr. West, the founder of Grace specializes in BAC so we have a lot of excellent material on the subject. The first 3 videos and transcripts are from his most recent discussions on BAC the best order in which to use is 3rd, 2nd, 1st http://cancergrace.org/lung/tag/ais/

I hope this is helpful and I hope more this isn't cancer. Either way please update us.
All best,
Janine

becktoria74
Thanks Janine.

Thanks Janine.

We had thought that perhaps the bloodwork would show something autoimmune going on to explain the mass. The pulmonologist is kind of amazed that I'm not having symptoms from a mass this size and I find it especially hard to believe that pneumonia or TB wouldn't be causing symptoms, especially for three years.

I'm 41 and aside from being about 50 pounds overweight am in good health. I smoked about a half a pack a day for 8 months around 2010. There's a strong history of cancer in my family, but no lung cancer.

I have a three year old and a one year old and am nervous but if it is BAC I'll be grateful we caught it this early.

becktoria74
Should also add that I have a

Should also add that I have a similar but much smaller growth in my right lower lobe and that my left hilar node is enlarged. I'll have a pre op exam, including ct scan, the day before the surgery and want to be prepared to talk with the surgeon about possibilities. I don't know if they'll just do the biopsy or if he'll say something along the lines of if it's x we can do y or z while we're in there.

Good lord I hate all the unknowns.

catdander
I can only imagine the worry

I can only imagine the worry of the unknowns for you. I'm very sorry for that. A discussion about what will happen with surgery will be important if they do find cancer. I will have a specialist comment on that. My question is whether you would remove that large a tumor if there is cancer in the other lung, making it not curable but possibly very treatable. In that case you want to maintain as much lung as possible because you'll need it in the future if cancer spreads. Again I don't know the answer and will have an expert explain.

All the very best,
Janine

Dr West
It's definitely concerning to

It's definitely concerning to have any opacity growing over time, especially if it's larger. It is certainly appropriate and important to get a tissue diagnosis, and I think if it's proven to be in the spectrum of cancer, to do a lobectomy (potentially at that time, but could also be delayed until later) if it's all confined in a single lobe.

Good luck.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Medical Oncologist
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education

becktoria74
Thanks again Janine.

Thanks again Janine.

That's what's got me worried about decision making. If it's a slew cancer that's spread in my lungs would it be smart to do a lobectomy without trying other treatments first and/or knowing more about what type of cancer it might be and possible mutations.

Still praying it's just some scarring from chronic aspiration or a treatable infection but trying to be prepared for everything.

Thanks again. This site is such a wonderful resource!

becktoria74
Thanks Dr. West. The

Thanks Dr. West. The question though is whether a lobectomy would still be smart if it's not confined to one lobe? In that case does it make more sense to get more information before deciding on the lobectomy?

Dr West
If it isn't confined to one

If it isn't confined to one lobe, then a lobectomy is likely to provide little value unless the other lesions haven't shown any hint of growth over a very long time (>1 yr). If there are other lesions in other lobes that have shown progression, then the surgery will just remove lung that would potentially be more valuable remaining in. That's a little less clear if the entire lobe is involved, but if it wouldn't be curative, there's very little reason to think that a big surgery will provide real benefit.

Good luck.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Medical Oncologist
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education

becktoria74
Thank you Dr. West.

Thank you Dr. West.

catdander
becktoria, If you have

becktoria, If you have access to a 2nd opinion that would help sort out the best way to move forward. Dr. Weiss has written this excellent post about all the good reasons why a 2nd is never a bad idea. One of the many things to know is no one person can hold all the information about all types of cancer in her head. That's why a specialist is helpful if only at transition points, at which you have definitely found yourself. (Dr. West has even suggested some of he more dedicated Grace users become as knowledgeable as specialists about his/her own predicament.
http://cancergrace.org/cancer-101/2011/11/13/an-insider%E2%80%99s-guide-...
Just a piece of unsolicited info to think about.

Janine

becktoria74
Thanks Janine. I'm fortunate

Thanks Janine. I'm fortunate that we have a decent cancer center that is part of the Seattle cancer care alliance. So if the biopsy does turn up a malignancy I'll have a great place to go for some direction and advice.

My main worry, that y'all have helped me resolve, was whether to go along with or request a lobectomy if they found something. Now I feel comfortable telling the surgeon to just do the biopsy and we'll go from there afterwards.

Thanks again. You've both been very helpful.

becktoria74
That second opinion article

That second opinion article is great by the way. Thanks for the info!

catdander
I'm just curious about the

I'm just curious about the surgery. I now think you are talking about a core biopsy and not a thoracotomy or VATS. Is that so?

becktoria74
I'll be having a VATS. We

I'll be having a VATS. We talked about doing a needle biopsy first but the pulmonologist didn't think it likely that we'd get a diagnosis that way. And I'm more confident in the surgeons and radiologists in the bigger city because of what I know about the local ones. So we decided to just go to vats and find out what we're dealing with. We've been trying to figure it out since January and the not knowing is wearing.

becktoria74
Ugh.

Ugh.

It doesn't change anything about how we're proceeding, but I just found out that the 3cm of growth may have happened over 7 months, not three years like I thought. Turns out that on the radiology report of my December 2015 ct scan the radiologist referenced a comparison to the May 2015 scan I had for the pulmonary embolism. Trying to find out for sure from my doc.

becktoria74
Okay so hazy area seen in

Okay so hazy area seen in 2012, approximately 3cm of growth and more ground glass appearance between May 2015 and December 2015. I have no idea what that means as far as the chances for diagnosis. Pulmonologist says it might be a good thing and point more to inflammation. We'll see next week I guess.

becktoria74
Another question before I

Another question before I talk to the surgeon: if the growth rates of the masses in each lung are significantly different and the larger left turns out to be malignant, is it safe to assume that the smaller mass on the right is the same cancer? Would that affect the decision to have a lobectomy of the left side?

JimC
I don't think you can

I don't think you can necessarily assume that the smaller mass in the right lung is also cancer, and even if so, that it is the same cancer. I would think that before you'd make the decision in favor of a lobectomy on the left side, you'd want to know what the mass on the right represents. If it is the same cancer, then a lobectomy would not be recommended; the choice would be systemic therapy.

JimC
Forum moderator

<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>

becktoria74
Thanks Jim. That's what I was

Thanks Jim. That's what I was thinking. So far nothing I've read our heard makes me think I should have a lobectomy immediately. If it does end up being a cancer we can find out what's going on for sure before we make any decisions.

becktoria74
So I had my biopsy. And on

So I had my biopsy. And on the ct scan the day before the radiologist noticed something on my liver. In the evening after the vats they did a full abdominal scan with contrast. Next morning the doc told me that it looked like cancer in the liver. Had a liver biopsy that afternoon. Still haven't gotten any official results. Surgeon said he still thought that the issue in the lungs might be some unrelated benign process. Once I get the calls on pathology I'll be making an appointment with an oncologist I guess.

becktoria74
Lung biopsy finally came back

Lung biopsy finally came back. Chronic organizing pneumonia. But at least it's benign and not related to the cancer so it's going on the back burner for the time being.

becktoria74
Final diagnosis is stage iv

Final diagnosis is stage iv colon cancer with tumors in my liver and microscope spots of the same adenocarcinoma in my lungs along with the chronic organizing pneumonia. Thanks all for your advice.

JimC
becktoria,

becktoria,

I'm sorry to hear of your diagnosis.

Sending you positive thoughts for success in treatment, minimal side effects and strength as you move forward.

JimC
Forum moderator

<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>